Case report: atypical presentation of suppurative thyroiditis in an immunocompetent patient with vascular involvement (Lemierre's syndrome)
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supperative thyroiditis

How to Cite

Rojas, W., Tovar, H., Vargas, J. J., & Tous, R. (2019). Case report: atypical presentation of suppurative thyroiditis in an immunocompetent patient with vascular involvement (Lemierre’s syndrome). Revista Endocrino, 6(3), 218–227.


The pathology of the thyroid gland, in its highest percentage, is constituted by thyroiditis, a wide range of diseases of different etiology (infectious, autoimmune or of unknown occurrence) and duration (acute, subacute or chronic). From the physiological point of view, they can vary in their presentation, causing hypothyroidism or thyrotoxicosis, or not altering the functioning of thyroid hormones.

Acute suppurative thyroiditis has a mainly infectious cause. It is an unusual condition, since the normal thyroid is particularly resistant to infections due to its extensive venous and lymphatic drainage, in addition to its high iodine content and the presence of a fibrous capsule, which serves as a shield against harmful external agents. Thyroid infections represent approximately 0.7% of all surgical pathologies in relation to this gland (1-3) and are more frequent in an abnormal thyroid gland. Despite the strangeness of this condition, it is important to know what its presentation is and its association in immunocompetent patients such as the vascular extension present in Lemierre’s syndrome, which this patient presented.

The objective of this report is to present a clinical case of a patient who had an episode of infectious thyroiditis, its management and the different causes of thyroiditis. An updated review of the topic and the different treatment options was carried out. This case was handled quickly with corticosteroids and antibiotics, as well as surgical drainage.

The patient recovered responding satisfactorily to the surgical and pharmacological management established. It is concluded that the treatment carried out was successful.
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1. Cawich SO, Hassranah D, Naraynsingh V. Idiopathic thyroid abscess. Int J Surg Case Rep. 2014;5(8):484-6.
2. Gady J, Piorkowski R. Infections of the thyroid gland. En: Hupp J, Ferneini EM (editor). Head, neck, and orofacial infections. 2016. p. 288-92.
3. Bravo E, Grayev A. Thyroid abscess as a complication of bacterial throat infection. J Radiol Case Rep. 2011;5:1-7.
4. Schweitzer VG, Olson NR. Thyroid abscess: otolaryngol. Head Neck Surg. 1981;89(2):226-9.
5. Jonas NE, Fagan JJ. Internal jugular vein thrombosis: a case study and review of the literature. Internet J Otorhinolaryngol. 2007;6:2.
6. Yedla N, Pirela D, Manzano A, Tuda C, Lo Presti S. Thyroid abscess: challenges in diagnosis and management. J Investig Med High Impact Case Rep. 2018;6.
7. Kottahachchi D, Topliss DJ. Immunoglobulin G4-related thyroid diseases. Eur Thyroid J. 2016;5(4):231-9.
8. Oroog A, Truran P, Aspinall S. Thyrotoxicosis and thyroiditis. Surgery (Oxford). 2017;35(10):569-75.
9. Falhammar H, Juhlin CC, Barner C, Catrina SB, Karefylakis C, Calissendorff J. Riedel’s thyroiditis: clinical presentation, treatment and outcomes Henrik Falhammar. Endocrine. 2018;60(1):185-92.
10. Rizzo L, Mana DL, Bruno OD. Tiroiditis no-autoinmunes. Medicina. 2014;74(6):481.
11. Keely EJ. Postpartum thyroiditis: an autoimmune thyroid disorder which predicts future thyroid health. Obstet Med. 2011;4(1):7-11.
12. Miyauchi A. Thyroid gland: a new management algorithm for acute suppurative thyroiditis? Nat Rev Endocrinol. 2010;6(8):424-6.
Lecturas recomendadas
• Elorza JL, Echenique-Elizonda M. Acute suppurative thyroiditis. J Am Coll Surg. 2002;195:729-30.
• García JC, Redondo J, Civera M, Verdú J, Pellicer V, Martínez MP. Management of thyroid gland abscess. Acta Otorrinolaringol. 2018;70(2):61-7.
• Goldani LZ, Zavascki AP, Maia AL. Fungal thyroiditis: an overview. Mycopathologia. 2006;161:129-39.
• Jeng LB, Lin JD, Chen MF. Acute suppurative thyroiditis: a ten year review in a Taiwanese hospital. Scand J Infect Dis. 1994;26:297-300.
• Mali VP, Prabhakaran K. Recurrent acute thyroid swellings because of pyriform sinus fistula. J Pediatr Surg. 2008;43:e27-30.
• McAninch EA, Xu C, Lagari VS, Kim BW. Coccidiomycosis thyroiditis in an immunocompromised host post-transplant: case report and literature review. J Clin Endocrinol Metab. 2014;99:1537-42.
• Paes JE, Burman KD, Cohen J, Franklyn J, McHenry CR, Shoham S, et al. Acute bacterial suppurative thyroiditis: a clinical review and expert opinion. Thyroid. 2010;20(3):247-55.
• Pearce EN, Farwell AP, Braverman LE. Thyroiditis. N Engl J Med. 2003;348(26):2646-55.
• Seo JH, Park YH, Yang SW, Kim HY. Refractory acute suppurative thyroiditis secondary to pyriform sinus fistula. Ann Pediatr Endocrinol Metab. 2014;9:104-7.
• Sheu SY, Schmid KW. Inflammatory diseases of the thyroid gland. Epidemiology, symptoms and morphology. Pathologe. 2003;24(5):339-47.
• Sioka E, Efthimiou M, Skoulakis C, Zacharoulis D. Thyroid abscess requiring emergency intervention. J Emerg Med. 2011;43(6):e455-6.
• Suprabha J, Vijay K, Shital P. Acute bacterial thyroid abscess as a complication of septicemia. IDCP. 2000;9:383-6.

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