Infectious complications following thyroid needle procedures: an underrecognized clinical challenge

Ultrasound-guided thyroid needle procedures, including fine-needle aspiration (FNA), percutaneous ethanol injection (PEI), and thermal ablation, are widely regarded as safe and effective. Infectious complications are exceptionally rare and may be underrecognized because their presentation can overlap with expected post-procedural inflammatory reactions or aseptic nodule rupture. We performed a focused narrative review of reported infections following thyroid needle procedures, examining their clinical presentation, microbiological findings, risk factors, and management. Published cases indicate that infections may occur after FNA, PEI, and thermal ablation, with considerable heterogeneity in timing, clinical severity, microbiological findings, and therapeutic approach. Reported management strategies range from antibiotic therapy alone to image-guided drainage or surgery, and no standardized treatment pathway is currently available. Early recognition, careful clinical and ultrasound assessment, and management tailored to disease severity are essential to limit progression to abscess formation or local and systemic complications. Greater awareness of these uncommon events may facilitate timely diagnosis and reduce both adverse outcomes and unnecessary interventions.