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Suppurative thyroiditis: Systematic review and clinical guidance.

Nicole Lafontaine1,2,3, Diana Learoyd4, Stephen Farrel5,6,7

  • 1Endocrinology and Diabetes Department, Eastern Health, Melbourne, Vic., Australia.

Clinical Endocrinology
|February 9, 2021
PubMed
Summary

Acute suppurative thyroiditis (AST) is a rare, potentially fatal condition. Early diagnosis is crucial as AST symptoms mimic subacute thyroiditis (SAT), requiring prompt medical attention for better outcomes.

Keywords:
subacutesuppurativethyroiditis

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Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Acute suppurative thyroiditis (AST) is a rare but life-threatening condition.
  • Distinguishing AST from subacute thyroiditis (SAT) can be challenging due to overlapping symptoms.

Purpose of the Study:

  • To provide an updated understanding of acute suppurative thyroiditis.
  • To review the epidemiology, clinical features, diagnosis, management, and outcomes of AST.

Main Methods:

  • A systematic review of English literature from January 2000 to January 2020.
  • Inclusion of all full-text cases of microscopy or culture-proven AST.

Main Results:

  • 200 cases of AST reported, most commonly bacterial (gram-positive aerobes).
  • Common symptoms include neck pain (89%) and fever (82%).
  • High mortality rates observed in fungal (33%) and tuberculous AST.

Conclusions:

  • AST diagnosis can be difficult due to symptom overlap with SAT.
  • Prompt consideration of AST is vital in systemically unwell patients with thyroiditis.
  • An evidence-based investigative and treatment strategy is proposed.