Thyroid Abscess 101: Usually a Post OP Surgical Complication.
- Recurrent mass occuring after thyroid surgery can be an abscess from a stitch left in. Antibiotics, incision and drainage may be all that is need.
- Another reason to make sure the thyroid surgery is really needed as major complications such as vocal cord nerve damage and calcium deficiency from parathyroid damage as well as abscess formation.
- A rare cause is a infection from E.Colli as described in this case.
- The case shown is an abscess caused by TB.
A case of idiopathic thyroid abscess caused by Escherichia coli
Suppurative thyroiditis with an abscess is a rare form of thyroiditis that can present as a diagnostic challenge. Its rarity is attributed to unique features of the thyroid gland that make it resistant to infection. Delay in diagnosis often can lead to morbid complications from the progression of the infection. Although more likely to be caused by gram-positive bacteria, gram-negative organisms are also known to cause this infection which often requires surgical treatment. The authors present a case of thyroid abscess from Escherichia coli from an unknown source.
Thyroiditis is an inflammation of the thyroid gland and may have a variety of etiologies [1 Begum A, Bari M, Ayaz K, et al. Thyroiditis – A review. J Med. 2006;7. DOI:10.3329/jom.v7i2.1366.]. The thyroid gland is usually resistant to infection due to its rich lymphatic drainage, dual blood supply, encapsulation, and iodine concentration. Thus, suppurative thyroiditis is a relatively uncommon cause of thyroiditis. Suppurative thyroiditis, including thyroid abscess, constitutes 0.7 to 1% of all thyroid diseases. It is usually caused by hematogenous spread or direct inoculation of a pathogen. Treatment includes systemic antibiotics targeting the causative organism although the gold standard remains surgical drainage.
Thyroid abscesses are uncommon and should be considered in patients presenting with unresolving symptoms of anterior neck pain and swelling. Prompt treatment is necessary to avoid complications and extension which may lead to airway compromise. Surgical management is the mainstay of managing the patients with thyroid abscesses.