The tender neck: thyroiditis or thyroid abscess?
Following apparent subacute thyroiditis, a 16-year-old girl developed a left thyroid abscess thought to be secondary to steroids and haematogenous spread from a pilonidal abscess. The thyroid suppuration became recurrent and required partial thyroidectomy. Further left-sided abscess formation in the neck prompted a barium swallow which revealed the source of infection to be a sinus tract arising from the left piriform fossa. The patent fourth branchial sinus tract was later excised. All patients with a tender thyroid should have ultrasound-guided fine needle aspiration to establish the diagnosis. If suppuration is confirmed, a barium swallow is advised to exclude a sinus tract from the piriform fossa.
Houghton
D J
DJ
Department of Otolaryngology, Head and Neck Surgery, Glasgow Royal Infirmary University NHS Trust, UK.
Gray
H W
HW
MacKenzie
K
K
D000038:Abscess / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D000293:Adolescent; D001707:Biopsy, Needle; D001934:Branchial Region / Q000002:abnormalities* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D010146:Pain / Q000209:etiology; D011877:Radionuclide Imaging; D012008:Recurrence; D013290:Streptococcal Infections / Q000175:diagnosis*; D013959:Thyroid Diseases / Q000175:diagnosis; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D013968:Thyroiditis, Subacute / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed