title: Non-surgical management of thyroid abscess with ultrasound-guided fine-needle application of an antibiotic followed by sclerotization with absolute alcohol.
abstract: Thyroid abscess is a relatively rare yet dramatic condition of the thyroid gland requiring immediate therapeutic intervention. Traditionally, more or less aggressive surgical approaches and administration of broad-spectrum antibiotics have been used. Clinically less severe disease allows non-surgical treatment as well. The case report describes successful treatment of a large abscess of iatrogenic origin after biopsy of a cystic cavity. A combination of broad-spectrum antibiotics was used based on culture results, administered both orally and by repeated application directly into the abscess cavity using an ultrasound-guided fine-needle approach. Concurrent repeated evacuation of the cavity replaced drainage. Ultimately, a small residual cavity with sterile contents was managed by sclerotization with absolute alcohol. Clinical condition permitting, thyroid abscess may be successfully treated by repeated application of a targeted antibiotic, using a fine needle and ultrasound guidance, directly into the abscess cavity, with repeated evacuation replacing drainage.
authors.affiliation: Third Department of Internal Medicine, Division of Endocrinology, University Hospital and Faculty of Medicineand Dentistry, Palacky Universit, Olomouc, Czech Republic - milan.halenka@fnol.cz.
authors.forename: M
authors.initials: M
authors.lastname: Halenka
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology / Q000628:therapy*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D044963:Biopsy, Fine-Needle / Q000009:adverse effects; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003560:Cysts / Q000473:pathology; D004754:Enterobacter / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology / Q000628:therapy*; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000627:therapeutic use*; D015911:Sclerotherapy; D013959:Thyroid Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology / Q000628:therapy*; D014140:Tracheotomy; D018084:Ultrasonography, Interventional; D014946:Wound Infection / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D012597:Sclerosing Solutions; D000431:Ethanol; D002939:Ciprofloxacin