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Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
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[Acute suppurative thyroiditis: A case report].

Susanna Hofdam1, Daniel Bengtsson2, Etsko Engel Blaauwwiekel3

  • 1ST-läkare medicinkliniken, Länssjukhuset i Kalmar.

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Summary

Acute suppurative thyroiditis (AST), a rare condition, can mimic subacute thyroiditis (SAT). This case highlights successful treatment of a thyroid abscess in an immunocompromised patient with surgical drainage and antibiotics.

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Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Acute suppurative thyroiditis (AST) is a rare and severe condition, often challenging to distinguish from subacute thyroiditis (SAT).
  • AST typically affects immunocompromised individuals or those with pre-existing thyroid conditions or anatomical abnormalities like pyriform sinus fistulas.

Purpose of the Study:

  • To report a case of acute suppurative thyroiditis in an immunocompromised woman.
  • To emphasize the diagnostic challenges and successful management of thyroid abscess.

Main Methods:

  • Clinical presentation of a 37-year-old immunocompromised woman with symptoms mimicking SAT.
  • Diagnostic workup including thyroid function tests (TSH, free T3, free T4).
  • Treatment involved surgical drainage of a thyroid abscess and oral antibiotics.

Main Results:

  • The patient presented with fever, fatigue, and anterior neck inflammation.
  • Initial treatment for suspected SAT with Prednisolone was ineffective.
  • Development of a thyroid abscess confirmed the diagnosis of AST.
  • Successful resolution of symptoms following surgical drainage and antibiotic therapy.

Conclusions:

  • AST requires prompt recognition and differentiation from SAT.
  • Surgical intervention and antibiotics are crucial for managing thyroid abscesses.
  • This case underscores the importance of considering AST in immunocompromised patients with thyroid inflammation.