Acute Suppurative Thyroiditis Secondary to Escherichia coli Infection.

UNLABELLED: Infections of the thyroid gland are rare. Its innate resistance to infections can be attributed to its unique anatomical features and rich blood supply. High clinical suspicion is required as a delay in diagnosis can lead to significant morbidity and mortality. Major pathogens include the Gram-positive Staphylococcus aureus and Streptococcus species; however, Gram-negative organisms have been found especially in immunocompromised hosts. We present a rare case of acute suppurative thyroiditis (AST) secondary to Escherichia coli (E. coli) infection in a woman known to be infected with human immunodeficiency virus (HIV).

LEARNING POINTS: Thyroid abscesses are rare and can be confused with more common pathologies involving the neck such as a goitre, adenoma, intracystic haemorrhage, pharyngeal abscess and subacute thyroiditis.A high index of suspicion for a thyroid abscess is required for patients who present with an anterior neck swelling to avoid a late diagnosis, which is associated with significant morbidity and mortality.Acute suppurative thyroiditis is more commonly caused by Gram-positive organisms. Gram-negative organisms such as E. coli remain a rare cause. However, if a thyroid abscess is suspected clinically, broad-spectrum antibiotics can be lifesaving before definite culture and sensitivity results are available.