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Thyroid Tuberculosis Abscess: A Systematic Review of Diagnostic Pathways and Management Strategies
Pranav Shivashankar1, Praween Senanayake2, Thomas Stephen Ledger3
1Department of Otolaryngology, Head and Neck Surgery, Prince of Wales Hospital, Sydney 2031, Australia.
Tropical Medicine and Infectious Disease
|March 27, 2026
Summary
Thyroid tuberculosis abscesses (TTA) are rare, but anti-tubercular therapy (ATT) is effective. Surgery is reserved for specific cases, with most patients achieving resolution and normal thyroid function.
Area of Science:
- Endocrinology
- Infectious Diseases
- Oncology
Background:
- Thyroid tuberculosis abscesses (TTA) are rare extrapulmonary tuberculosis manifestations.
- Literature primarily consists of case reports and small observational studies.
Purpose of the Study:
- To systematically review management strategies and clinical outcomes for TTA.
- To evaluate the effectiveness of current treatment approaches for thyroid tuberculosis.
Main Methods:
- Systematic literature search of PubMed, Embase, Web of Science, and Google Scholar (1990-2025).
- Included studies with confirmed TTA, treatment regimens, and outcomes; excluded suspected cases.
- Risk of bias assessed using the Joanna Briggs Institute tool; 22 studies (33 patients) analyzed.
Main Results:
- Diagnostic delays were common; standard four-drug anti-tubercular therapy (ATT) was the primary treatment.
- Surgery or drainage was used for large abscesses, treatment failure, or suspected malignancy.
- 92% of patients showed lesion resolution and preserved euthyroid function; publication bias is a concern.
Conclusions:
- TTA is rare, with successful treatment outcomes using ATT, reserving surgery for select cases.
- Higher-quality comparative data are needed to optimize TTA management strategies.
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