Thyroid disease is defined as a condition of malfunction of thyroid.
Hyperthyroidism is a condition in which the thyroid gland is over active
and produces too much thyroid hormones. Hypothyroidism is a condition
in which the thyroid gland is under active and produces very little
thyroid hormones. Thyroid cancer is defined as condition in which the
cells in the thyroid gland have become cancerous.
Acute thyroiditis (Acute infectious thyroiditis or acute suppurative
thyroiditis) is defined as a condition of as a result of relatively high
amount of iodine in the tissue causes of microbial inflammatory
thyroiditis, pyrogenic thyroiditis and bacterial thyroiditis. Acute
infectious thyroiditis is very rare, accounting for about 0.1-0.7% of
all thyroiditis.
B. Causes and Risk Factors
B.1. Causes
According to the study by the Georgetown University, the most common
anaerobic bacteria are Gram-negative bacilli and Peptostreptococcus spp.
Agents that are rarely recovered include Klebsiella spp., Haemophilus
influenzae, Streptococcus viridans, Salmonella spp., Enterobacteriaceae,
Mycobacterium tuberculosis, atypical mycobacteria, Aspergillus spp.,
Coccidioides immitis, Candida spp., Treponema pallidum, and Echinococcus
spp. Viruses have been associated with subacute thyroiditis, and
include measles, mumps, influenza, enterovirus Epstein-barr, adenovirus,
echovirus, and St Louis encephalitis(7).
There is a report of two cases of bacterial suppurative thyroiditis
caused by Streptococcus anginosus(8) . Other report that cute
suppurative thyroiditis in a patient with prior subacute thyroiditis(9),
and cute suppurative thyroiditis caused by an infected piriform sinus
fistula with thyrotoxicosis(10). The Ito Hospital report of a case of
Cervical thymic cyst as a cause of acute suppurative thyroiditis(11).
Other rarer pathogens include fungi, parasites(12).
B.2. Risk Factors
1. Immunocompromised patients
People who have weakened immune system are at increased risk of
bacterial, virus and fungal causes of cute infectious thyroiditis.
2. Elderly
If you are elder, you are associated with increased of cute infectious thyroiditis.
3. Pre-existing Thyroid diseaseand Elderly
There is a report of a case of suppurative thyroiditis occurring in a
72-year-old woman is reported. The clinical history of this woman,
treated by tianeptine for mild exogenous affective disorder and by
conventional insulin therapy for long-standing insulin-dependent
diabetes, was remarkable for the pseudotumoral signs which led to the
simultaneous diagnosis of hypothyroidism due to Hashimoto’s thyroiditis
and of mycobacterium avium intracellulare suppurative thyroiditis(13).
4. Congenital defect
4.1. Complete congenital third branchial fistula
There is a report of a nine-year-old boy presented with a history of a
small opening in the middle third of the anterior neck since birth, with
recurrent surrounding swelling. There was no history of surgical
drainage or spontaneous rupture. Computed tomography with contrast
injection into the external cervical opening revealed a patent tract
from the neck skin to the base of the pyriform sinus. Complete excision
of the tract up to the pyriform sinus with left hemithyroidectomy was
performed. Follow up at 22 months showed no recurrence(14).
4.2. Fourth branchial arch anomalies
Fourth branchial arch anomalies represent <1% of all branchial
anomalies and present as recurrent neck infections or suppurative
thyroiditis(14a).
4.1. Persistent thyroglossal duct
There is a report of Thyroid imaging in a typical case of acute
suppurative thyroiditis with abscess formation due to infection from a
persistent thyroglossal duct(15).
4.2. Piriform sinus fistula
There is a report of an acute suppurative thyroiditis as a result of an infected piriform sinus fistula with thyrotoxicosis(16).
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Sources
(7) http://www.ncbi.nlm.nih.gov/pubmed/12697345
(8) http://www.ncbi.nlm.nih.gov/pubmed/23435638
(9) http://www.ncbi.nlm.nih.gov/pubmed/1298872
(10) http://www.ncbi.nlm.nih.gov/pubmed/11916288.
(11) http://www.ncbi.nlm.nih.gov/pubmed/2243452
(12) http://link.springer.com/article/10.1007%2Fs11908-000-0027-7
(13) http://www.ncbi.nlm.nih.gov/pubmed/8006334
(14) http://www.ncbi.nlm.nih.gov/pubmed/20156371
(14a) http://www.ncbi.nlm.nih.gov/pubmed/23478017
(15) http://www.ncbi.nlm.nih.gov/pubmed/8074961
(16) http://www.ncbi.nlm.nih.gov/pubmed/11916288
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