title: Thyroidal abscesses in third and fourth branchial anomalies: not only a paediatric diagnosis.
abstract: BACKGROUND
  Acute suppurative thyroiditis and recurrent abscess formation due to third and fourth branchial anomalies typically present in children. However, thyroid abscesses in branchial anomalies may occur in adulthood as well. Failure to recognize and delayed drainage of a neck abscess may lead to a fulminant life-threatening outcome.
  
  
  METHODS
  This is a retrospective case series. The study group comprised all patients presenting over a 12-month period from January to December 2012 with thyroid abscesses and a branchial cleft anomaly in two centres, one adult and the other paediatric. Patient demographics, clinical presentation, imaging, surgical management, definitive histology and outcomes were documented.
  
  
  RESULTS
  Five patients were identified with a history of thyroid abscesses. Only one was a child (aged 9 years) with the other four being adults (aged 20, 34, 37 and 41 years). All patients had third or fourth left branchial cleft anomalies, presenting as suppurative thyroiditis with a left-sided thyroid abscess. Management options ranged from abscess drainage on initial presentation, primary thyroid lobectomy or delayed thyroid lobectomy following abscess drainage.
  
  
  CONCLUSIONS
  Acute suppurative thyroidits and thyroid abscesses is not just a paediatric diagnosis but may present at any age. In both children and adults, a thyroid abscess almost always arises from branchial cleft anomalies.
authors.affiliation: Endocrine Surgical Unit, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Schelto
authors.initials: S
authors.lastname: Kruijff
authors.affiliation: Endocrine Surgical Unit, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Sywak
authors.affiliation: Endocrine Surgical Unit, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Stan B
authors.initials: SB
authors.lastname: Sidhu
authors.affiliation: Department of Surgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
authors.forename: Albert
authors.initials: A
authors.lastname: Shun
authors.affiliation: Otolaryngology, Head and Neck Surgery, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Novakovic
authors.affiliation: Endocrine Surgical Unit, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: James C
authors.initials: JC
authors.lastname: Lee
authors.affiliation: Endocrine Surgical Unit, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Leigh W
authors.initials: LW
authors.lastname: Delbridge
mesh_terms: D000038:Abscess / Q000601:surgery*; D000328:Adult; D001934:Branchial Region / Q000002:abnormalities*; D002648:Child; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods; D013966:Thyroiditis / Q000601:surgery*; D016896:Treatment Outcome
keywords: acute suppurative thyroiditis; third and fourth branchial anomalies; thyroidal abscesses