Smit Maaike P, Abdullahi Najma S, Bakker Boudewijn, van den Elzen Annette P M
Reinier de Graaf Gasthuis, afd. Kindergeneeskunde, Delft.
Contact: A.P.M. van den Elzen (
Ned Tijdschr Geneeskd. 2018 Nov 26;162:D3081.
Haemolytic group A streptococci (GAS) are the most common bacterial cause of infection in the Netherlands. These bacteria can cause many different non-invasive infections, including scarlet fever.
A two-year-old girl presented with fever, tachycardia, exanthema and swelling in the neck. On suspicion of scarlet fever with neck phlegmon we treated her with antibiotics and supportive therapy. Blood and throat cultures revealed growth of haemolytic GAS. Lab tests revealed mild hyperthyroidism and neck ultrasound revealed an inhomogeneous appearance of the thyroid. We diagnosed her with 'infectious thyroiditis', a rare complication of infection with haemolytic GAS. A fistula from the pyriform sinus could not be demonstrated.
Although GAS infections are common, complications such as thyroiditis are rare. When a paediatric patient is diagnosed with infectious thyroiditis, a fistula from the pyriform sinus should be considered. Patients with such a congenital malformation have an increased risk of recurrent infectious thyroiditis and thyroid abscess formation.
A 组溶血性链球菌（GAS）是荷兰最常见的细菌感染病因。这些细菌可引发多种不同的非侵袭性感染，包括猩红热。
一名两岁女童出现发热、心动过速、皮疹及颈部肿胀。因怀疑猩红热合并颈部蜂窝织炎，我们对她进行了抗生素治疗及支持治疗。血液和咽喉培养显示有 A 组溶血性链球菌生长。实验室检查显示轻度甲状腺功能亢进，颈部超声显示甲状腺外观不均匀。我们诊断她患有“感染性甲状腺炎”，这是 A 组溶血性链球菌感染的一种罕见并发症。未发现梨状窦瘘。
尽管 GAS 感染很常见，但甲状腺炎等并发症很少见。当儿科患者被诊断为感染性甲状腺炎时，应考虑梨状窦瘘。患有这种先天性畸形的患者复发性感染性甲状腺炎和甲状腺脓肿形成的风险增加。
