Thyroid Abscess

Alaqeab E, Elghobashy M*, Matin A and Almanassra A

Department of ENT and Head and Neck, University Hospital Limerick, co. limerick, Ireland

^*Correspondance to: Mohamed Elghobashy 

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Abstract:

The thyroid gland is inherently resistant to infection due to its abundant lymphatic drainage, dual blood supply, encapsulation and high iodin concentration. Suppurative thyroiditis is an uncommon type of thyroiditis, including thyroid abscess, accounts for only 0.7% to 1% of all thyroid diseases. Staphylococcus aureus is the most frequently isolated organism. Streptococcus, pneumococcus, salmonella, klebsiella and rarely mycobacterium, are examples of bacteria that are involved in many AST. A 42-year-old healthy female with 3 days history of fever and painful anterior neck swelling associated with odynophagia with no history of neck trauma. Examination showed anterior neck swelling in thyroid region, firm and tender and erythema over the overlying skin. No clinical lymphadenopathy was detected. Throat examination with fiberscope was normal. White blood cell count was high with neutrophilia, increased erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) . Ultrasonography thyroid showed enlarged right thyroid lobe with 2cm hypoechoic nodule. Antibiotics (ceftriaxone, flucloxacillin intravenous and clindamycin tablets), propranolol tablets, recommended by endocrinologist, dexamethasone intravenous. By day 10 after improvement on antibiotics, unexpectedly the patient became febrile clinically ill, with rapid progression of a growing mass on the right side of her neck and high WBCs and high CRP. The computed tomography with contrast showed a notable enlargement of the right thyroid lobe with abscess formation. Under general anaesthesia, 30 ml of pus was drained. Streptococcus constellatus (milleri) was isolated that showed resistance to clindamycin and sensitivity to penicillin. Meropenem intravenous was applied according to microbiologist consultation for two weeks. 6 weeks follow up showed Interval ultrasonic resolution of the right thyroid abscess, no pathological nodule was detected, with normal thyroid function test.

Keywords:

Thyroid

Cite the Article:

Alaqeab E, Elghobashy M, Matin A, Almanassra A. Thyroid Abscess. Ann Clin Case Rep. 2025; 10: 2770..