Anwar Sumadi Lukman, Wahyono Artanto, Dwianingsih Ery Kus, Avanti Widya Surya
Division of Surgical Oncology, Dr. Sardjito Hospital/Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia.
Department of Pathological Anatomy, Dr. Sardjito Hospital/Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia.
IDCases. 2022 Jun 20;29:e01544. doi: 10.1016/j.idcr.2022.e01544. eCollection 2022.
Tuberculosis remains the highest cause of infection-related mortality in low- and middle-income countries. Extra-pulmonary tuberculosis is often misdiagnosed because of the nonspecific clinical presentations and gaps in the laboratory assessment. Delayed and misdiagnosis can cause increased risks of morbidity and potential community transmission. Primary thyroid tuberculosis is very rare presentation even in the endemic area. We presented a Case Illustrated of a patient with cold abscess as a primary presentation of thyroid tuberculosis. Difficulty in the diagnosis and treatment were described. Although very rare, atypical presentation of extra-pulmonary tuberculosis in the thyroid gland requires thorough anamnesis and in-depth examination. Clinicians should put high-index suspicion on high-risk patients from endemic areas with medical comorbidity including immunocompromised disease and poor nutritional status. Our report underlines the importance of thorough medical assessment for unusual presentation of thyroid tuberculosis.
结核病仍然是低收入和中等收入国家感染相关死亡的首要原因。肺外结核病常因临床表现不具特异性以及实验室评估存在差距而被误诊。诊断延误和误诊会增加发病风险及潜在的社区传播风险。即使在结核病流行地区，原发性甲状腺结核的表现也非常罕见。我们展示了一例以冷脓肿为原发性甲状腺结核表现的病例说明。描述了诊断和治疗中的困难。尽管非常罕见，但甲状腺 gland 中肺外结核病的非典型表现需要全面的病史采集和深入检查。临床医生应高度怀疑来自结核病流行地区且患有包括免疫功能低下疾病和营养不良状况在内的内科合并症的高危患者。我们的报告强调了对甲状腺结核异常表现进行全面医学评估的重要性。
