Management of thyroid gland abscess

Acta Otorrinolaringol Esp (Engl Ed). 2019 Mar-Apr;70(2):61-67. doi: 10.1016/j.otorri.2018.01.005. Epub 2018 Jun 9.
[Article in English, Spanish]

Abstract

Background: Thyroid abscess or acute suppurative thyroiditis is an unusual clinical condition. We present our experience with cases attended over 41 years.

Materials and methods: A retrospective study was performed on these patients reviewing their epidemiological characteristics and the diagnostic and therapeutic manoeuvres chosen for them all, as well as their clinical outcome. A group of 9 males and 5 females was studied, with ages ranging from 19 to 68 (mean of 40.6±15.4). These patients suffered 22 acute episodes, and 2 patients each had 4 episodes.

Results: Suppurative thyroiditis comprised 0.29% of the neck abscesses. Fine needle aspiration was performed in 13 cases to evacuate the collection and isolate the aetiological agent. Mycobacterium tuberculosis and Staphylococcus aureus were the most frequently identified. Nine patients underwent ultrasound and 7 computed tomography imaging studies. Surgery was the option for 10 patients, including drainage for 7, thyroidectomy for 4 and hemithyroidectomy for the remaining 2. Systemic or intralesional antibiotics and sclerosis of the gland were also carried out. Although one case presented with hyperthyroidism and thyrotoxicosis in the acute phase, definitive hypothyroidism was observed in 5 patients at 6 months following discharge. The rate of success was 100%.

Conclusion: Thyroid gland suppuration is a very infrequent circumstance in neck pathology, and the options for its treatment are varied, from conservative to invasive techniques according to the microbial and radiologic findings.

Keywords: Absceso cervical; Cervical tuberculosis; Enfermedades infecciosas del cuello; Glándula tiroides; Infectious neck diseases; Neck abscess; Thyroid gland; Tuberculosis cervical.

MeSH terms

  • Abscess* / diagnosis
  • Abscess* / epidemiology
  • Abscess* / microbiology
  • Abscess* / therapy
  • Acute Disease
  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Drainage
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Therapeutic Irrigation
  • Thyroid Diseases* / diagnosis
  • Thyroid Diseases* / epidemiology
  • Thyroid Diseases* / microbiology
  • Thyroid Diseases* / therapy
  • Thyroidectomy
  • Thyroiditis, Suppurative* / diagnosis
  • Thyroiditis, Suppurative* / epidemiology
  • Thyroiditis, Suppurative* / microbiology
  • Thyroiditis, Suppurative* / therapy
  • Young Adult

Substances

  • Anti-Bacterial Agents