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Cryptococcal thyroiditis: report of a case diagnosed by fine-needle aspiration cytology
1Department of Pathology, Woodhull Medical & Mental Health Center, Brooklyn, NY.
Insights
A rare fungal thyroid infection caused by Cryptococcus neoformans occurred in a diabetic patient with respiratory distress. This case highlights emerging mycotic thyroid infections and an efficient diagnostic method.
Area of Science:
- Infectious Diseases
- Endocrinology
- Pulmonology
Background:
- Diabetes mellitus is a common comorbidity associated with increased susceptibility to infections.
- Thyroid gland infections are rare, with fungal etiology being exceptionally uncommon.
- Cryptococcus neoformans is an opportunistic fungus typically causing meningoencephalitis or pulmonary disease.
Observation:
- A 54-year-old female with diabetes presented with fever, respiratory distress, and bilateral alveolar infiltrates.
- Physical examination revealed an enlarged left thyroid lobe with reduced pertechnetate uptake, despite the patient being euthyroid.
- Fine-needle aspiration (FNA) of the thyroid and blood cultures identified Cryptococcus neoformans.
Findings:
- The patient's respiratory condition, attributed to Cryptococcus neoformans, led to a fatal outcome.
- The thyroid gland was identified as a site of mycotic infection by Cryptococcus neoformans.
- The study demonstrated the utility of FNA in diagnosing thyroidal fungal infections.
Implications:
- This case underscores the potential for Cryptococcus neoformans to cause thyroid infections, particularly in immunocompromised individuals.
- Early and accurate diagnosis of mycotic thyroid infections is crucial for appropriate management and improved patient outcomes.
- The presented diagnostic method offers an efficient approach for identifying fungal pathogens in thyroid tissue.
Abstract:
A 54-yr-old female diabetic presented with a febrile illness and respiratory distress associated with bilateral alveolar infiltration. The left lobe of the thyroid gland was enlarged and failed to concentrate pertechnetate. The patient was euthyroid. Cryptococcus neoformans was recognized in a fine-needle aspirate and was confirmed by culture; it was also grown in blood culture. Death was attributed to the respiratory condition. This report emphasizes the emergence of mycotic infections of the thyroid and presents an efficient method for their identification.