From Gut to Goiter: How Salmonella Gastroenteritis Causes Thyroid Abscess

The innate characteristics of the thyroid gland that resist infection render thyroid abscesses extremely uncommon. Moreover, gram-negative species, such as Salmonella spp., are a rare cause of thyroid abscess from hematogenous dissemination.

A 41-year-old postpartum, breastfeeding female developed neck swelling and dysphagia following gastroenteritis. Imaging revealed a thyroid abscess. Fine needle aspiration (FNA) identified purulent fluid positive for Salmonella spp. Although the patient was initially responsive to antibiotics, recurrent swelling, dysphagia, and transient thyrotoxicosis developed, requiring re-admission. Successful treatment included culture-specific antimicrobials, ultrasound (US)-guided needle drainage, and beta blockers, eliminating the need for surgical intervention.

This case highlights a unique Salmonella thyroid abscess from hematogenous spread of infection in an immunocompetent individual. While thyroid abscesses, particularly those caused by Salmonella spp., are rare, clinicians should maintain a broad differential diagnosis, especially following gastrointestinal illness. FNA with culturing, imaging, and targeted antimicrobial therapy is crucial for timely diagnosis and favorable outcomes.