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Khoo KS, Koh PS, Ng KL. Salmonella thyroid abscess-two case reports. Gland Surg 2020; 9:2198-2203. [PMID: 33447571 DOI: 10.21037/gs-20-474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Acute suppurative thyroiditis account for <1% of thyroid diseases and is uncommon because of the gland's encapsulation, iodine-rich environment, good vascular supply and extensive lymphatic drainage. It has been reported in patients with underlying goiters, thyroid cancers and in immuno-compromised patients. The usual causative organisms are Staphylococci spp. and Streptococci spp. Rarer organisms include Klebsiella spp. and Salmonella spp. Due to its rarity (as there have been only 28 cases of Salmonella thyroid abscess being reported in the literature till 2020), only case reports are available to guide management. We report two cases of thyroid abscess due to Salmonella enteritidis in our institution that may herald the re-emergence of this uncommon infection of the thyroid gland and to raise awareness for all clinicians. Both patients presented with neck swelling, dysphagia and sepsis. Surgical intervention was warranted in both patients due to the severity of the disease and failed medical therapy. Recovery was uneventful following adequate surgical intervention and antibiotic therapy according to the culture and sensitivity report of the pathogen. This case report highlights that both patients were immunocompromised, and they contracted Salmonella thyroid abscess without any gastrointestinal involvement. Thus, a high index of suspicion for Salmonella thyroid abscess in immunocompromised patients can expedite the diagnosis and appropriate management can be commenced such as antibiotic therapy, percutaneous aspiration and surgical drainage in the event of failed medical therapy.
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Affiliation(s)
- Kah Seng Khoo
- Surgical Resident, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Peng Soon Koh
- General & Hepato-biliary Surgeon, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Khoon Leong Ng
- General & Endocrine Surgeon, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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AlYousef MK, Al-Sayed AA, Al Afif A, Alamoudi U, LeBlanc JM, LeBlanc R. A pain in the neck: Salmonella spp. as an unusual cause of a thyroid abscess. A case report and review of the literature. BMC Infect Dis 2020; 20:436. [PMID: 32571225 PMCID: PMC7310241 DOI: 10.1186/s12879-020-05161-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/15/2020] [Indexed: 11/10/2022] Open
Abstract
Background Thyroid gland infections are rare. Their incidence is estimated to be less than 1% in immunocompromised hosts. Most common pathogens isolated are Gram positive aerobic cocci. Infections with Gram negative facultative aerobes such as Salmonella are rare. Case presentation A 55-year-old female with type II diabetes mellitus and a history of a colloid right thyroid lobe nodule presented with neck pain and fever. She was found to have a thyroid abscess 2 weeks following a non-specific diarrheal illness. A needle aspiration for symptomatic and diagnostic purposes was performed. Cultures grew Salmonella enterica serotype Heidelberg. She was treated with a 12-week course of oral antibiotics and serial aspiration. Conclusion A thyroid abscess is a rare occurrence; however, a high index of suspicion is required to make the diagnosis. The management is directed at minimizing morbidity. The mainstay treatment is medical, but surgery is sometimes necessary to achieve adequate source control, particularly when complications arise.
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Affiliation(s)
- Maha K AlYousef
- School of Education, Acadia University, 22 Crowell Drive, Wolfville, NS, B4P 2R6, Canada
| | - Ahmed A Al-Sayed
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, B3K 6R8, Canada. .,Department of Otolaryngology Head and Neck Surgery, King Saud University, Riyadh, Saudi Arabia.
| | - Ayham Al Afif
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, B3K 6R8, Canada
| | - Uthman Alamoudi
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, B3K 6R8, Canada.,Department of Otolaryngology Head and Neck Surgery, Hail University, Hail, Saudi Arabia
| | - Jaclyn M LeBlanc
- Division of Infectious Disease, Department of Internal Medicine, Dalhousie University, 5780 University Avenue, Halifax, NS, B3H 1V7, Canada
| | - Robin LeBlanc
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, B3K 6R8, Canada
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