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Partially Treated Acute Suppurative Thyroiditis in a Healthy Child Caused by Streptococcus pyogenes
Haitam Almoffarreh1, Nouf Alkaabi1, Abdullatif Alkhurayji1
1Pediatric Emergency Medicine, King Abdullah Specialist Children's Hospital, King Abdulaziz Medical City, Riyadh, SAU.
Insights
Thyroid abscess is rare, especially in children. This case highlights a pediatric thyroid abscess successfully treated with drainage, despite prior antibiotic use and mediastinal extension.
Area of Science:
- Endocrinology
- Pediatric Surgery
- Infectious Diseases
Background:
- Thyroid abscess is a rare clinical diagnosis, often linked to congenital anomalies in pediatric cases.
- Prompt recognition and treatment are crucial to prevent severe complications like airway compromise.
- Atypical presentations can arise from prior inadequate treatment.
Observation:
- A 15-month-old female presented with anterior neck swelling and a confirmed thyroid abscess.
- Despite disease extension to the mediastinum, she had no severe systemic illness, possibly due to prior oral antibiotic treatment.
- No congenital anomalies were identified in this patient.
Findings:
- The pediatric thyroid abscess originated from the left thyroid lobe and extended into the mediastinum.
- Cultures identified Streptococcus pyogenes as the causative pathogen.
- The patient was successfully managed with open surgical drainage.
Implications:
- This case underscores the importance of considering thyroid abscess in pediatric neck masses, even with atypical presentations.
- Surgical drainage remains a critical intervention for thyroid abscesses, particularly with extensive disease.
- Prompt and appropriate management can lead to favorable outcomes, even in complex pediatric cases.
Abstract:
Thyroid abscess is a rare encounter due to its unique histological and structural features. It is usually associated with some form of congenital anomalies in pediatrics especially if recurred. Early recognition and treatment are of paramount importance in preventing complications. Atypical presentation can occur if the patient is improperly treated prior to presentation. Conservative management is becoming the mainstay of treatment unless there is a risk of airway compromise or extension. We report the case of a 15-month-old female who presented with anterior neck swelling. She received oral antibiotics prior to her visit and did not exhibit severe systemic illness despite her disease extension. She was found to have a thyroid abscess originating from the left thyroid lobe extending to the mediastinum. No congenital anomalies were found. She was managed with open drainage and her cultures grew Streptococcus pyogenes.
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