From the University of Maryland School of Medicine.
University of Maryland Medical Center, Baltimore, MD.
Pediatr Emerg Care. 2021 Dec 1;37(12):e1416-e1418. doi: 10.1097/PEC.0000000000002062.
The aim of this study was to determine if microbiological cultures can guide management of suppurative thyroiditis.
This study is a retrospective case series set in 2 tertiary care academic hospitals.
The microbiological cultures from patients with suppurative thyroiditis who underwent incision and drainage from July 2004 to June 2018 were reviewed. Those who had confirmed pyriform sinus tracts and underwent surgical intervention were included in the study.
Fifteen patients satisfied the criteria for inclusion. All had confirmed pyriform sinus tracts and underwent successful intervention. Endoscopic cautery was the most common intervention followed by complete open excision. Five cultures grew alpha Streptococcus, 6 had Eikenella, and 4 Prevotella. Combinations of Eikenella + Prevotella were seen in 3, and 1 sample had all 3 bacteria. Two cultured methicillin-susceptible Staphylococcus aureus alone. One culture was sterile.
The presence of oral flora in an intrathyroidal abscess is confirmatory evidence of a pyriform sinus tract. Further investigations are not needed, and early definitive intervention can be planned.
本研究旨在确定微生物培养能否指导甲状腺脓性炎的治疗。
本研究是一项回顾性病例系列研究，在 2 家三级保健学术医院进行。
对 2004 年 7 月至 2018 年 6 月期间因甲状腺脓性炎而行切开引流的患者的微生物培养进行回顾。纳入研究的患者均有明确的梨状窝窦道，并接受了手术干预。
15 名患者符合纳入标准。所有患者均有明确的梨状窝窦道，且均成功接受了干预。最常见的干预措施是内镜电灼，其次是完全开放性切除。5 例培养出甲型链球菌，6 例培养出埃肯菌，4 例培养出普雷沃菌。3 例同时存在埃肯菌+普雷沃菌，1 例样本中同时存在这 3 种细菌。2 例单独培养出耐甲氧西林金黄色葡萄球菌，1 例培养结果无菌。
甲状腺脓肿中出现口腔菌群是梨状窝窦道的明确证据。无需进一步检查，可以尽早进行确定性干预。
