Acute suppurative thyroiditis in a 13-year-old boy: a rare pediatric case report

Thyroid abscess is an uncommon condition in children due to the gland's natural resistance to infection, provided by its encapsulation, vascularity, lymphatic drainage, and iodine content. Delay in diagnosis may result in serious complications such as airway compromise and mediastinitis. Early recognition and appropriate intervention are essential to prevent morbidity.

A pediatric boy presented with a 2-month history of anterior neck swelling that had rapidly increased in size over the preceding 2 weeks, associated with 1 week of fever. Examination showed a tender, warm, oval swelling over the left thyroid lobe that moved with swallowing, along with ipsilateral cervical lymphadenopathy. Laboratory studies revealed mild leukocytosis with neutrophilia and elevated C-reactive protein, while thyroid function tests were normal. Neck ultrasound demonstrated a phlegmonous inflammatory process with a small intrathyroidal fluid collection; computed tomography (CT) was unavailable. Fine-needle aspiration cytology indicated pyogenic thyroiditis, and culture grew Staphylococcus aureus. He underwent left hemithyroidectomy with drainage of necrotic tissue and pus. His postoperative recovery was uneventful, and he was discharged in good condition.

Pediatric thyroid abscess is rare and often mimics other neck pathologies, contributing to delayed presentation. In resource-limited settings, ultrasound and fine needle aspiration cytology provide adequate diagnostic guidance when CT is unavailable. Surgical intervention remains the mainstay of treatment, especially in cases of significant necrosis or well-formed abscesses. This case highlights the effectiveness of timely surgical management in achieving excellent outcomes.

Thyroid abscess should be considered in children with progressive neck swelling and fever. Early diagnosis and timely surgical management are vital to prevent complications and ensure favorable outcomes.