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Pneumocystis carinii thyroiditis.

J E Gallant1, R E Enriquez, K L Cohen

  • 1Department of Medicine, West Haven Veterans Administration Medical Center, Connecticut.

The American Journal of Medicine
|February 1, 1988
PubMed
Summary
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Pneumocystis carinii (P. carinii) was found in the thyroid of an immunocompromised patient, expanding the understanding of extrapulmonary pneumocystosis. This case demonstrates successful treatment of thyroidal P. carinii infection with trimethoprim/sulfamethoxazole.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Endocrinology

Background:

  • Acquired immunodeficiency syndrome (AIDS) and intravenous drug abuse are risk factors for opportunistic infections.
  • Pneumocystis carinii pneumonia (PCP) is a common opportunistic infection in individuals with AIDS.
  • Thyroidal involvement with P. carinii is rare and typically associated with severe, fatal pulmonary disease.

Observation:

  • A 38-year-old man with AIDS presented with unilateral neck swelling and abnormal thyroid imaging.
  • Fine-needle aspiration of the thyroid confirmed the presence of P. carinii.
  • Pulmonary evaluation revealed nodules and cavitary lesions, but bronchoalveolar lavage and biopsy were negative for P. carinii.

Findings:

  • This case represents a rare instance of isolated thyroidal Pneumocystis carinii infection.

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  • The patient's thyroid function tests were normal, despite the presence of the organism.
  • Successful treatment was achieved using trimethoprim/sulfamethoxazole.

    • Implications:

    • This case expands the known clinical spectrum of extrapulmonary pneumocystosis.
    • It highlights the importance of considering P. carinii in the differential diagnosis of thyroid masses in immunocompromised patients.
    • The successful treatment suggests that trimethoprim/sulfamethoxazole may be effective for thyroidal P. carinii infections, even in the absence of severe pulmonary disease.