Coccidioidal Infection of the Thyroid

Abstract

Infection of the thyroid gland with Coccidioides immitis, the causative agent of coccidioidomycosis, is very rarely recognized antemortem. We report 2 recent cases, one immunosuppressed by corticosteroid treatment of sarcoidosis and the other without any recognized impairment of host defenses. In the first case, thyroid gland involvement was but 1 indication of disseminated infection. In the second case, the patient appeared to have autoimmune thyrotoxicosis without clinical evidence of coccidioidomycosis elsewhere. Although historical autopsy studies have indicated that coccidioidal involvement of the thyroid gland can infrequently occur as part of fatal disseminated infection, to our knowledge only 2 other cases of infection detected during life have been reported. Optimal treatment of this rare complication of coccidioidomycosis is uncertain.

Thyroid fine-needle aspiration of an immunocompromised patient: Cytomorphological clues

“…The utility of FNA to diagnose pulmonary coccidioidomycosis has also been well established. [11] Although several case reports have shown coccidioidomycosis of the thyroid gland,[121314] the diagnosis is often made by microbiologic culture, serology, or histology with special stains, this case illustrates that coccidioidomycosis of the thyroid gland can be diagnosed correctly by FNA cytology.…”

Coccidioidomicosis extrapulmonar: Presentación de un caso y revisión de la literatura

“…Predominan en el género masculino, usualmente, en un contexto de inmunosupresión. Afectan comúnmente la piel, las meninges y huesos, así como sitios menos comunes como la glándula tiroides, la conjuntiva y el pericardio [10][11][12] . Se han informado lesiones osteolíticas con reacción perióstica 6 , abscesos fríos, empiemas, fístulas tóraco-costales, neumonías y formas miliares.…”

Diagnosis and management of infectious thyroiditis

“…Fungal infections of the thyroid are extremely rare and are usually seen in the setting of dissemination [20,21]. The thyroid gland has a rich vascular supply and can therefore be prone to infectious seeding during either bacteremia or fungemia.…”