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[急性化脓性甲状腺炎伴多种并发症]

[Acute suppurative thyroiditis with multiple complications].

作者信息

Fonseca Izabela Fernandes Alves da, Avvad Cristina Kayat, Sanchez Eduardo Guilherme, Henriques Jodélia Lima Martins, Leão Lenora M Camarate S M

机构信息

Programa de Especialização Lato Sensu em Endocrinologia, Diabetes e Metabologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.

出版信息

Arq Bras Endocrinol Metabol. 2012 Aug;56(6):388-92. doi: 10.1590/s0004-27302012000600008.

Abstract

Acute suppurative thyroiditis is a rare disorder, most often caused by Staphylococcus aureus or Streptococcus pneumoniae, which affects particularly children with pyriform sinus fistula. In adults, the main pathogenic mechanism seems to be hematogenous dissemination from a focus of infection in the oropharynx or respiratory tract. The initial signs and symptoms of acute thyroiditis are similar to those of acute pharyngitis and subacute thyroiditis. This fact often delays diagnosis and increases the risk of complications. We report the case of a previously healthy, 28-year-old man who, after being affected by tonsillitis, developed suppurative thyroiditis complicated by thyrotoxicosis; a large abscess in the right lobe of the thyroid extending to the thorax introitus, which caused a trachea deviation and compressed large vessels; associated with internal jugular vein thrombosis, and sepsis.

摘要

急性化脓性甲状腺炎是一种罕见疾病,最常由金黄色葡萄球菌或肺炎链球菌引起,尤其影响患有梨状窦瘘的儿童。在成人中,主要致病机制似乎是口咽部或呼吸道感染灶的血行播散。急性甲状腺炎的初始体征和症状与急性咽炎和亚急性甲状腺炎相似。这一事实常常延误诊断并增加并发症风险。我们报告一例病例,一名28岁既往健康男性,在患扁桃体炎后发生化脓性甲状腺炎并并发甲状腺毒症;甲状腺右叶有一个大脓肿延伸至胸廓入口,导致气管移位并压迫大血管;伴有颈内静脉血栓形成和脓毒症。

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