Acute Suppurative and Subacute Thyroiditis: From Diagnosis to Management

Area of Science:

• Endocrinology
• Infectious Diseases
• Pediatrics

Background:

• Acute suppurative thyroiditis (AST) and subacute thyroiditis (SAT) are distinct inflammatory thyroid conditions.
• AST is a rare bacterial infection, often in children, linked to congenital anomalies.
• SAT is a self-limiting, post-viral condition causing temporary thyroid dysfunction.

Purpose of the Study:

• To differentiate the epidemiology, presentation, diagnosis, and treatment of AST and SAT.
• To highlight the importance of accurate diagnosis and tailored management for both conditions.
• To review current literature, with a focus on pediatric cases.

Main Methods:

• Comprehensive literature review using PubMed and UpToDate.
• Inclusion of systematic reviews, meta-analyses, case series, and case reports.
• Focus on studies detailing epidemiology, pathophysiology, clinical presentation, diagnosis, and treatment, especially in pediatric populations.

Main Results:

• AST is rare (<1% of thyroid diseases), more common in children, with pyriform sinus fistulas in 21% of cases; requires antibiotics and drainage.
• SAT is common in adult women post-viral infection; presents with neck pain and transient thyrotoxicosis; managed with NSAIDs or corticosteroids.
• Accurate differential diagnosis is crucial to avoid unnecessary interventions.

Conclusions:

• Both AST and SAT require timely diagnosis and tailored treatment to prevent complications.
• Advances in imaging improve AST outcomes; SAT management focuses on symptom relief.
• Further research is needed on risk factors, pathogenesis, and optimal treatments, especially in pediatric and resource-limited settings.