Acute Suppurative Thyroiditis in Children

Abstract

CHICAGO Acute suppurative thyroiditis in children appears to be extremely uncommon. Accurate statistics as to its frequency are lacking. In the better known monographs on the thyroid gland and in the various treatises on surgery and pediatrics, it is dismissed with a brief statement as to its extreme rarity and grave prognosis. For example, Means and Richardson 1 stated that "in young children acute thyroiditis is ordinarily fatal," while in another paragraph they said that "suppurative thyroiditis may lead to serious complications and even death through mediastinitis, perforation of trachea or esophagus, or from associated edema and pressure."The literature pertaining to the condition is relatively barren. Demme 2 was reported to have seen congenital strumitis in a new-born infant. Burhans,3 in a recent compilation of the reports of sixty-seven cases of acute thyroiditis from the recent literature, found two patients between the ages of 1 and 10 years, one of whom was 18 months old.No data were given as to the type of inflammation and the treatment given. Baratta4 reported a case in an infant, aged 2 months, with marked pressure phenomena, in which relief was obtained by repeated aspiration.In a previous communication. 15 pointed out that acute inflammatory lesions of the thyroid gland are nearly always secondary to acute infec¬ tions elsewhere in the body, the latter being most commonly situated in the upper or lower respiratory tract. In the cases here reported the

Thyrotoxicosis Due to Acute Suppurative Thyroiditis in a Pediatric Patient: A Case Report

“…Acute suppurative thyroiditis is a rare and potentially lifethreatening diagnosis that if unrecognized can lead to complications such as tracheal compression and airway compromise, bacteremia, mediastinitis, or abscess rupture with extension into adjacent structures. [1][2][3][4][5][6] Reviews of AST cases from the early 20th century report mortality rates up to 25%. 2,7 A more recent review of AST cases reported in the literature in the late 20th century reports a much lower, but still significant mortality rate of 3.7% with deaths predominantly occurring in immunocompromised patients.…”

Acute Suppurative Thyroiditis in Children

“…AST presents as an inflammatory process in the anterior neck. AST is often associated with a recent upper respiratory infection or otitis media, 1 and hematogenous or lymphogenous spread has been suggested as the route of infection 2–4 . It has also been suggested that children and adults are predisposed to thyroid infection by preexisting thyroid disease, direct invasion from contiguous structures, presence of a thyroglossal duct remnant, blunt trauma, or a left pyriform sinus fistula 2–6 .…”