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Spontaneous thyroid abscesses without underlying malignancy: a differential diagnosis for recent onset or rapidly
J McAllister1, S P Balasubramanian2,3
1The University of Sheffield Medical School, UK.
Annals of the Royal College of Surgeons of England
|August 27, 2021
Summary
Thyroid abscess is a rare but serious condition, often presenting as neck swelling. Prompt diagnosis and antibiotic treatment are crucial for recovery, especially in immunocompromised individuals.
Area of Science:
- Endocrinology
- Infectious Diseases
- Surgical Pathology
Background:
- Thyroid abscess is an uncommon cause of neck swelling, with bacterial growth typically inhibited by the thyroid's environment.
- Immunocompromised patients, particularly those with diabetes mellitus, are at increased risk.
- Rapidly growing thyroid masses warrant consideration of thyroid abscess as a differential diagnosis.
Observation:
- Two cases of thyroid abscess in immunocompromised octogenarian women are presented.
- Clinical presentation included neck lumps, confirmed as thyroid abscesses via ultrasound and aspiration.
- Escherichia coli was identified as the causative pathogen in both cases.
Findings:
- Both patients presented with diabetes mellitus and elevated inflammatory markers.
- Treatment involved antibiotics, leading to complete resolution of the infection.
- No underlying thyroid neoplasm was detected in either patient.
Implications:
- Thyroid abscess requires urgent consideration in immunocompromised patients with rapidly developing neck masses.
- Prompt medical intervention, including admission for prompt management, is essential for favorable outcomes.
- Early diagnosis and treatment can prevent rapid deterioration and facilitate recovery.
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