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

Abstract

A 79-year-old woman with acute suppurative Salmonella thyroiditis is reported. She presented with fever and an enlarged, painful thyroid mass. Diagnosis was suspected by clinical symptoms and signs and confirmed by ultrasound, neck magnetic resonance imaging, aspiration cytology, and culture. The culture of fine-needle aspirate yielded Salmonella typhimurium. She was treated by parental antibiotics and surgical drainage. The source and route of infection remained unclear under a series of examinations. No piriform sinus fistula was evident on the imaging study. A hematogenous spread seems to be the most possible route.

Campylobacter jejuni as a Cause of Acute Infectious Thyroiditis, on a Background of SLE-related End Stage Renal Failure and CMV Viraemia: A Case Report and Review of the Literature

“…Although acute bacterial suppurative thyroiditis is a rare condition with only 224 cases existing in the literature between 1900 and 1980 [8,11] and totalled at 415 in 2010 [1], it is one that ought to be considered in any patient with known thyroid abnormalities or disease who presents with non-specific symptoms and potential underlying sepsis [1]. Failure to recognise the condition at an early stage can have catastrophic consequences and can lead to significant morbidity or death.…”

“…Numerous cases of other organisms are reported, in particular Gram-negative bacteria including Klebsiella pneumoniae, Salmonella species, Pasteurella multocida, Brucella, Escherichia coli, and Haemophilus influenzae amongst many others [11,13,[17][18][19][20]. In immunocompromised individuals, there is an additional tendency for fungal infection including Pneumocystis jiroveci, and Aspergillus and Candida species [10,19], although fungal infections may indeed be present in immunocompetent individuals, e.g.…”

Salmonella thyroid abscess in human immunodeficiency virus‐positive man: A diagnostic pitfall in fine‐needle aspiration biopsy of thyroid lesions

“…Acute suppurative thyroiditis (AST) is extremely rare, representing 0.1%–0.7% of all thyroid disease . This low incidence may be explained by the gland's rich vascularity, protective capsule, and high iodine content . Staphylococcus and Streptococcus species are the causative organisms in the majority of cases of AST.…”

“…According to Paes, gram negative aerobes account for approximately 25% of AST, with about 30% of AST being polymicrobial. Salmonella thyroid abscess is exceedingly rare and only a few cases have been reported . Because this entity is quite virulent and can be rapidly fatal, especially in an HIV‐positive patient, it represents a potentially important pitfall in fine needle aspiration (FNA) biopsy.…”

“…Piriform sinus fistula is thought to be the most common cause, and was identified by radiography in a large proportion of patients with AST. The incidence of fistula was dependent upon the imaging modality . Direct extension of abscess, neck trauma, ruptured esophagus, lymphatic or hematogenous spread in an anatomically altered thyroid (due to nodule or malignancy), and direct inoculation of the thyroid or surrounding structures (such as with intravenous drug abuse, FNA or central line placement) may represent other causes.…”