Endocrine Abstracts

Aims

Studying the clinical presentation, paraclinical explorations, and therapeutic modalities of thyroid abscess.

Materials and methods

We report the observation of a diabetic patient with multiple thyroidian abscesses, hospitalized in the ENT department.

Observation

The patient is 55 years old, diabetic, treated one month before admission for urinary tract infection. She came to us for increasing lower anterior cervical enlargement rapidly evolving volume in a febrile environment. On examination: Swelling of 3cm of large firm axis, mobile at swallowing, softening with Inflammatory signs looked on. The rest of the exam was without peculiarities. Biology: biological inflammatory syndrome ( leukocytosis at 12100, accelerated VS and CRP high) blood glucose 10 mmol/l, hyperthyroidism with TSH at 0.11 µUI/l and T4 at 30 pg/ml. Cervical ultrasound: thyroid gland of altered appearance heterogeneous site of multiple formations cystic hypoechogenic. Cervical CT: multiple well-defined hypodense lesions with peripheral elevation after injection. The puncture brought back frank pus with bacteriological examination: a Klebsiella pneumoniae. Before the history of urinary tract infection, an ECBU was practiced, it allowed to isolate after culture the same germ. The patient was given antibiotic therapy adapted to the isolated germ. Evolution: collection at the end of 5 days which had needed its flattening under general anesthesia. The suites were simple.

Conclusion

Thyroid abscesses are a rare pathological entity. This may be suppurated thyroiditis complicated by an abscess, a thyroid abscess developed in contact with a contiguous infectious home, or from a secondary location to a remote infectious home. The diagnosis of thyroid abscesses is often delayed given the polymorphism of clinical pictures. The most commonly encountered germs are streptococcus and staphylococcus. Treatment is based on intravenous antibiotic therapy adapted to the antibiogram associated with a surgical procedure.