Acute Suppurative Salmonella Thyreoiditis: Clinical Course and Antibody Response

Abstract

A previously healthy 72-year-old man, who had been treated with steroids for one month on a presumptive diagnosis of polymyalgia rheumatica, developed a suppurative thyreoiditis. Salmonella enteritidis was isolated from the thyroid aspirate. Although the bacterial strain was sensitive to ampicillin in vitro, the disease was not cured until treatment with trimethoprim-sulfamethoxazole was initiated. The patient developed a high antibody response of the IgM class against both salmonella serogroup B and D O-antigenic determinants, as estimated by enzyme-linked immunosorbent assay (ELISA). Absorption studies suggested that most of the antibody response was directed against salmonella 012 determinant(s), common to both salmonella serogroup B and D.

Acute Suppurative Thyroiditis Caused bySalmonella typhimurium:A Case Report and Review of the Literature

“…The underlying disorder included steroid use, diabetes mellitus, human immunodeficiency virus infection, thyroid follicular carcinoma, and nontoxic goiter (10)(11)(12)(13)(14)(15)(16)(17). In these reports, the routine cultures were usually sterile, except one stool culture and three blood cultures that were positive (14,15,17). Females were affected more than males.…”

“…Salmonella paratyphi A (case 1), Salmonella cholera-suis (case 2), Salmonella enteritidis (cases 3, 7, and 8), Salmonella brandenburg (case 4), Salmonella typhi (cases 5 and 6), and Salmonella typhimurium (case 9) are isolated in previous cases with Salmonella thyroiditis (Table 1). Salmonella typhi was a common pathogen of acute suppurative thyroiditis previously (1,3), but nontyphoidal Salmonella recently became a more important pathogen than typhoidal Salmonella in acute suppurative thyroiditis (10)(11)(12)(13)(14)(15)(16)(17). The underlying disorder included steroid use, diabetes mellitus, human immunodeficiency virus infection, thyroid follicular carcinoma, and nontoxic goiter (10)(11)(12)(13)(14)(15)(16)(17).…”

“…Salmonella typhi was a common pathogen of acute suppurative thyroiditis previously (1,3), but nontyphoidal Salmonella recently became a more important pathogen than typhoidal Salmonella in acute suppurative thyroiditis (10)(11)(12)(13)(14)(15)(16)(17). The underlying disorder included steroid use, diabetes mellitus, human immunodeficiency virus infection, thyroid follicular carcinoma, and nontoxic goiter (10)(11)(12)(13)(14)(15)(16)(17). In these reports, the routine cultures were usually sterile, except one stool culture and three blood cultures that were positive (14,15,17).…”

Acute Suppurative Salmonella Thyroiditis in a Patient With Graves Disease and Fluoroquinole Resistance

“…One hospital-based surveillance study from 2001 10 in Taiwan found a growing proportion of S choleraesuis isolates resistant to fluoroquinolones. 11 Most were treated with surgical drainage combined with antibiotics. Typing of these organisms from humans and pigs demonstrated identical amino acid substitutions at 2 sites, suggesting a role for initiating treatment of fluoroquinolone in animals.…”