Akhanlı Pınar, Bayır Ömer, Bayram Seyit Murat, Hepşen Sema, Badirshaev Madamin, Çakal Erman, Saylam Güleser, Korkmaz Mehmet Hakan
University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Ankara Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey.
Einstein (Sao Paulo). 2020 Mar 23;18:eRC5273. doi: 10.31744/einstein_journal/2020RC5273. eCollection 2020.
Acute suppurative thyroiditis is a very rare and life-threatening endocrine emergency. Thyrotoxicosis is a rare condition accompanying acute suppurative thyroiditis. While the majority of the cases in the literature are caused by different reasons, spontaneous development is very rare. We present a patient with acute suppurative thyroiditis who presented to our clinic with thyrotoxic findings, and we compared the case to the literature. A 31-year-old male patient was admitted to our clinic with a complaint of progressive neck pain, swelling and redness on midline neck, fever, and palpitations. On physical examination, swelling, redness and tenderness were detected on the neck region that was consistent with the thyroid location. He presented with tremor on the hands, tachycardia and agitation. Thyroid function tests were compatible with thyrotoxicosis, but there were findings supporting the presence of infection in biochemistry tests. On his radiological evaluations, a heterogeneous lesion divided with small septs was observed, with consolidation areas in the left thyroid lobe. In fine needle aspiration biopsy, 2mL of purulent fluid could be aspirated due to the presence of small, separated consolidation areas. He initiated on antibiotic therapy, propranolol, steroid and symptomatic treatment. Eikenella corrodens was detected on the culture antibiogram. Antibiotic therapy was continued for 14 days due to less symptoms and better biochemical values. After treatment, the patient had normal thyroid function, had relief of fever and redness of the neck, and was followed-up. It should be kept in mind that acute suppurative thyroiditis may develop spontaneously with the findings of thyrotoxicosis, with no risk factors.
急性化脓性甲状腺炎是一种非常罕见且危及生命的内分泌急症。甲状腺毒症是急性化脓性甲状腺炎伴发的一种罕见病症。虽然文献中的大多数病例由不同原因引起，但自发发生的情况非常罕见。我们报告一例以甲状腺毒症表现就诊于我们诊所的急性化脓性甲状腺炎患者，并将该病例与文献进行比较。一名31岁男性患者因进行性颈部疼痛、颈部中线肿胀、发红、发热和心悸的主诉入院。体格检查时，在与甲状腺位置相符的颈部区域发现肿胀、发红和压痛。他表现出手部震颤、心动过速和烦躁不安。甲状腺功能检查结果与甲状腺毒症相符，但生化检查中有支持感染存在的发现。在他的影像学评估中，观察到一个有小分隔的不均匀病变，左甲状腺叶有实变区域。在细针穿刺活检中，由于存在小的、分隔的实变区域，可抽出2mL脓性液体。他开始接受抗生素治疗、普萘洛尔、类固醇和对症治疗。在培养抗菌谱上检测到啮蚀艾肯菌。由于症状减轻和生化指标改善，抗生素治疗持续了14天。治疗后，患者甲状腺功能正常，颈部发热和发红症状缓解，并进行了随访。应记住，急性化脓性甲状腺炎可能在无危险因素的情况下自发出现甲状腺毒症表现。
