[Clinical study of 15 children with acute suppurative thyroiditis].
From 1969 to 1990, 15 children with acute suppurative thyroiditis (AST) were diagnosed in our hospital. Their clinical, laboratory and radiologic findings were reviewed. The characteristic features were as follows: 1) Males to female ratio was 1.5:1. 2) The ages at diagnosis ranged from 3 to 14 years, with a mean age of 6 years. 3) A painful, tender mass in the anterior neck was detected in all cases and fever was detected in 10 cases (67%). 4) The left lobe of the thyroid was affected in 11 cases (73%), whereas the right lobe was affected in the remaining 4 cases. No cases was bilateral. 5) Five cases (33%) were found to be recurrent. 6) Eight pathogenic organisms were identified on culture from 7 cases; among them 3 were due to anaerobic pathogen. 7) Leukocytosis was increased and acute-phase reactant tests were positive in most cases. 8) Thyroid function was found to be normal in all 9 cases examined. 9) Radiologic studies, which included radionuclide thyroid scan, ultrasonography, computed tomography and barium esophagogram, were very helpful for the diagnosis of AST. 10) A barium esophagogram was performed in 9 cases and a fistula originating from the pyriform sinus was found in 4 cases (44%). 11) Three cases (20%) had the complete removal of the fistula as a permanent cure. This report summarizes the clinical features of 15 children with acute suppurative thyroiditis diagnosed in our hospital during the past twenty years.
Onishi
H
H
Department of Pediatrics, School of Medicine, Chiba University.
Wataki
K
K
Sasaki
N
N
Niimi
H
H
D000208:Acute Disease; D000293:Adolescent; D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D004937:Esophageal Fistula / Q000000981:diagnostic imaging / Q000209:etiology; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D008297:Male; D011877:Radionuclide Imaging; D013959:Thyroid Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D013969:Thyroiditis, Suppurative / Q000150:complications / Q000175:diagnosis / Q000382:microbiology; D014057:Tomography, X-Ray Computed