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Gao Q, Zou W, Sun N, Xu S, Dong J, Song J, Han Y. A case report of acute suppurative thyroiditis caused by Clostridium perfringens. Future Microbiol 2023; 18:163-171. [PMID: 36916465 DOI: 10.2217/fmb-2022-0099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
A 42-year-old woman inadvertently discovered a neck mass, which caused pain. Initially, she was treated with antibiotics at a local clinic; however, this treatment did not alleviate the symptoms. She visited the authors' outpatient clinic for further treatment and underwent thyroid ultrasonography, which revealed a mixed echo nodule. On day 4 after admission, surgery was performed to remove the diseased thyroid tissue and levofloxacin (0.4 g/day) was infused. Bacterial culture confirmed infection with Clostridium perfringens. Subsequently, the treatment was switched to ceftriaxone sodium (2 g/day) according to the results of the drug sensitivity test. Following treatment, the patient recovered fully and was discharged. She was then followed up with after discharge. Ultrasonography, laboratory testing and clinical manifestations did not indicate obvious abnormalities.
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Affiliation(s)
- Qiang Gao
- Department of Thyroid Surgery, Binzhou Medical University Hospital, Binzhou City, Shandong Province, China
| | - Weiwei Zou
- Department of Thyroid Surgery, Binzhou Medical University Hospital, Binzhou City, Shandong Province, China
| | - Nannan Sun
- Department of Operating Room, Binzhou Medical University Hospital, Binzhou City, Shandong Province, China
| | - Shujian Xu
- Department of Thyroid Surgery, Binzhou Medical University Hospital, Binzhou City, Shandong Province, China
| | - Jinyu Dong
- First Clinical College of Binzhou Medical University, Binzhou City, Shandong Province, China
| | - Jia Song
- First Clinical College of Binzhou Medical University, Binzhou City, Shandong Province, China
| | - Yong Han
- Department of Thyroid Surgery, Binzhou Medical University Hospital, Binzhou City, Shandong Province, China
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Zhai A, Peng X, Guo Y, Li J, Shao J. Multimodal imaging of congenital pyriform fossa fistula in children. Front Pediatr 2023; 11:1089241. [PMID: 37025293 PMCID: PMC10072278 DOI: 10.3389/fped.2023.1089241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/21/2023] [Indexed: 04/08/2023] Open
Abstract
Objective Our aim was to explore the clinical value of multimodal imaging examinations in the diagnosis of congenital pyriform fossa fistula in children, so as to provide clues for the early diagnosis and treatment of congenital pyriform fossa fistula. Methods The clinical and imaging data of 55 children with pyriform fossa fistula diagnosed surgically in our hospital from 2015 to 2018 were analyzed retrospectively. All 55 patients underwent a CT scan. Of those patients, contrast enhancement CT was performed in 47 cases, MRI was performed in 2 cases, and barium esophagography was performed in 41 cases. Results Among the 55 cases, there were 24 male patients and 31 female patients. The age ranged from 11 months to 13 years old, and the median age was 3.8 years old. The lesions of 49 cases (89.1%) were located on the left side, and the imaging of CT showed soft tissue mass in the anterior cervical region blurred boundary. There was ipsilateral thyroid involvement in 50 cases (90.9%), trachea and/or carotid sheath extension in 43 cases (78.2%), abscess formation in 39 cases (70.9%), and pneumatosis in 25 cases (45.5%). The CT examination of 22 children after treatment showed a linear or tubular low-density shadow in the thyroid gland, gas accumulation in the anterior cervical region or thyroid, and residual contrast medium, partly. A total of 24 cases underwent barium esophagography during the acute phase, and 15 cases (62.5%) showed sinus formation from the pyriform fossa downward or punctate high-density shadow in the anterior cervical region. The 2 cases where MRI was performed showed abscess formation in one side of the neck and thyroid involvement. Conclusion Pyriform fossa fistula is most common in the left anterior cervical region, and it is closely related to the thyroid gland. The plain and enhanced-contrast CT scan can be used as the first choice during the infection stage. It helps to understand the location, extent, and structure of the surrounding tissue. The preliminary diagnosis of pyriform sinus fistula was according to the imaging features. It provided an important basis for clinical diagnosis and reduced the pain caused by repeated infection or surgical incision and drainage.
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Büttner A, Galster M. [Female patient with dysphagia, Staphylococcus aureus sepsis and thrombophlebitis]. Z Gerontol Geriatr 2021; 54:434-435. [PMID: 34279692 DOI: 10.1007/s00391-021-01919-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/04/2021] [Indexed: 11/28/2022]
Affiliation(s)
- A Büttner
- Universitätsklinik für Geriatrie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität Nürnberg, Prof.-Ernst-Nathan-Straße 1, 90419, Nürnberg, Deutschland.
| | - M Galster
- Universitätsklinik für Radiologie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität Nürnberg, Nürnberg, Deutschland
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Otani H, Notsu M, Koike S, Morita M, Yamamoto M, Yamauchi M, Fuchiwaki T, Morikura I, Aoi N, Kawauchi H, Iwabashi T, Araki A, Ishikawa N, Maruyama R, Sugimoto T. Acute suppurative thyroiditis caused by thyroid papillary carcinoma in the right thyroid lobe of a healthy woman. Thyroid Res 2018; 11:4. [PMID: 29785209 PMCID: PMC5952856 DOI: 10.1186/s13044-018-0049-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 05/06/2018] [Indexed: 11/10/2022] Open
Abstract
Background The thyroid gland is resistant to microbial infection, because of its organ characteristics such as encapsulation, iodine content, and rich blood supply. Therefore, acute suppurative thyroiditis (AST), as a bacterial infection of the thyroid gland, is rarely seen. AST typically takes places on the left side the neck region in children, because of the coincidence of the left piriform sinus fistula, as a most common route of infection. AST is also usually seen in immunocompromised hosts. Herein, we report a rare case of AST in the right thyroid lobe of adult woman without any immunocompromised condition. Case presentation A 59-year-old woman was introduced to our hospital for the further examination with fever, sore throat, and right anterior neck swelling. The patient appeared not to be immunodeficient. Neck ultrasonography showed a 47-mm, hypoechoic, heterogeneous nodule with ill-defined margins and irregular form, suggesting a right thyroid malignant nodule. Fine needle aspiration (FNA) biopsy specimen revealed numerous number of neutrophils in the background without nuclear atypia. Based on the clinical course and cytology, AST was confirmed to be diagnosed. Complete response was obtained by an intravenous administration of antimicrobial agents within a week. Image findings such as CT scan did not show any piriform sinus fistula. Four months later, neck ultrasonography showed a significant decrease in size of the nodule in the right thyroid gland to 27 mm, but the lesion still resembled a malignant nodule. So, FNA was repeated again and cytological examination confirmed papillary thyroid carcinoma (PTC). The patient subsequently underwent total thyroidectomy and bilateral level D1 lymph node dissection. Histological findings revealed a 20-mm PTC in the right lobe with sternothyroid muscle invasion of the tumor. Conclusions This report represents a rare case of AST associated with PTC on the right side of thyroid gland, found in a healthy adult woman. The reason why AST coincided with malignant thyroid tumor is unclear. We have to take it into our account that malignant tumor may exist in the background when AST is identified on the right side of thyroid gland with a healthy subject.
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Affiliation(s)
- Hazuki Otani
- 1Department of Internal Medicine 1, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Masakazu Notsu
- 1Department of Internal Medicine 1, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Sayo Koike
- 1Department of Internal Medicine 1, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Miwa Morita
- 1Department of Internal Medicine 1, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Masahiro Yamamoto
- 1Department of Internal Medicine 1, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Mika Yamauchi
- 1Department of Internal Medicine 1, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Takahumi Fuchiwaki
- 2Department of Otorhinolaryngology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Ichiro Morikura
- 2Department of Otorhinolaryngology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Noriaki Aoi
- 2Department of Otorhinolaryngology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Hideyuki Kawauchi
- 2Department of Otorhinolaryngology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Teruaki Iwabashi
- 3Department of Pathology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Asuka Araki
- 3Department of Pathology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Noriyoshi Ishikawa
- 3Department of Pathology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Riruke Maruyama
- 3Department of Pathology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Toshitsugu Sugimoto
- 1Department of Internal Medicine 1, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
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