OVERVIEW

What is acute suppurative thyroiditis?

Acute suppurative thyroiditis is a bacterial infection of the thyroid gland and is relatively rare. It is more likely to occur in immunocompromised individuals such as the elderly, children, diabetic patients, and those with AIDS.

Main symptoms include fever, neck pain, and limited mobility, with occasional pain in the ears.

Treatment involves antibiotic therapy and surgical incision to drain pus.

Is acute suppurative thyroiditis common?

This disease is uncommon.

The thyroid gland has a complete capsule, making bacterial invasion difficult. Additionally, the thyroid has rich blood circulation and lymphatic drainage, along with high concentrations of iodine ions, all of which contribute to its resistance to infection. Therefore, thyroid infections rarely occur.

SYMPTOMS

What are the manifestations of acute suppurative thyroiditis?

• Fever and tachycardia may occur.
• Neck swelling and tenderness. Neck movements such as flexion, lateral flexion, or rotation may be affected. Throat pain may occur when tilting the head backward or swallowing. Sometimes, pain may radiate to the ear or head and neck, and occasionally hoarseness may develop.
• Some patients may also experience redness and swelling of the skin on the front of the neck.

Can acute suppurative thyroiditis cause hyperthyroidism or hypothyroidism?

Generally, it does not alter thyroid function, but some cases may be accompanied by hypothyroidism or hyperthyroidism, and occasionally severe hyperthyroidism may occur.

If hypothyroidism develops, long-term levothyroxine treatment may be required.

What diseases can acute suppurative thyroiditis cause?

It can lead to complications such as hypothyroidism.

Additionally, if left untreated or inadequately treated, thyroid abscesses may spread to surrounding areas, causing severe complications such as mediastinal abscess or tracheoesophageal fistula. If the abscess ruptures forward, it may form a subcutaneous abscess. Severe abscesses can compress the trachea, leading to suffocation and difficulty breathing.

CAUSES

What are the causes of acute suppurative thyroiditis?

• It is often related to congenital developmental abnormalities in the neck, which is more common in children.
• It is also associated with pre-existing thyroid conditions, such as thyroid cysts, nodular tumors, and subacute thyroiditis, which is more common in adults.
• Additionally, it may be linked to weakened immunity, such as in patients with diabetes, tuberculosis, leukemia, AIDS, or those undergoing radiotherapy or immunosuppressive therapy, leading to thyroid infection.

Is acute suppurative thyroiditis contagious?

No.

Who is more susceptible to acute suppurative thyroiditis?

The elderly, children and adolescents, diabetic patients, AIDS patients, and others with weakened immune systems.

DIAGNOSIS

What tests might be needed for acute suppurative thyroiditis?

Blood tests, thyroid ultrasound, and CT scans are required. Thyroid ultrasound and CT scans can detect abscesses, while blood tests often indicate elevated white blood cell counts.

Additionally, a puncture under ultrasound guidance can be performed to examine the extracted fluid (pus) and conduct drug sensitivity tests to determine the cause of infection and select appropriate treatment medications.

Which diseases have symptoms similar to acute suppurative thyroiditis?

It needs to be differentiated from subacute thyroiditis, thyroid nodule rupture, Hashimoto's thyroiditis, and malignant thyroid tumor necrosis, which can be distinguished through ultrasound.

TREATMENT

Which department should I visit for acute suppurative thyroiditis?

It is recommended to first visit the endocrinology department. If surgery is required after diagnosis, you will be referred to the surgery department.

How is acute suppurative thyroiditis treated?

Antibiotic treatment is generally required. If antibiotics fail to control the infection or abscess progression, surgical incision and drainage of the abscess are necessary.

Does acute suppurative thyroiditis require surgery? What are the risks of surgery?

Surgical incision and drainage are necessary once an abscess forms.

In addition to anesthesia risks, surgery may cause hypothyroidism or damage the recurrent laryngeal nerve, leading to hoarseness, among other complications.

Is follow-up required after surgery for acute suppurative thyroiditis?

Post-surgery follow-up includes thyroid ultrasound and thyroid function tests. If hypothyroidism symptoms appear, long-term medication is required.

Can acute suppurative thyroiditis be completely cured?

Most cases of acute suppurative thyroiditis have a good prognosis with proper and effective antibiotic treatment, leading to full recovery without sequelae or hypothyroidism.

Severe cases may result in hypothyroidism, requiring levothyroxine replacement therapy. A very small number of patients may develop chronic thyroid enlargement, necessitating surgical intervention.

DIET & LIFESTYLE

What should be paid attention to in life and diet for acute suppurative thyroiditis?

During treatment, pay attention to rest and avoid colds, pharyngitis, and tonsillitis attacks.

There are no special dietary restrictions, but pain may affect chewing and swallowing food, so try to eat less hard food.

PREVENTION

How to Prevent Acute Suppurative Thyroiditis?

Generally, avoid catching colds and boost immunity. Seek medical attention promptly if neck pain occurs.