Acute Thyroid Abscess Secondary to Oesophageal Perforation

Abstract

Acute thyroid abscess is rare, however this report describes the case of a 71-year-old male with an acute thyroid abscess resulting from oesophageal perforation who was successfully treated with antibiotic (cefotaxime sodium), neck exploration and a right subtotal thyroidectomy. The patient reported ingesting a fish bone and, although this had been dislodged, he experienced continuing pharyngalgia and fever. An anterior neck swelling with tenderness and erythema was noted at the level of the right thyroid. At operation, the recurrent laryngeal nerve was identified and preserved, and a large part of the right thyroid was excised. During the 5-year follow-up period, deglutition function and thyroid function tests remained normal. This result indicates that early administration of antibiotic, and surgical treatment of the infection source and affected thyroid tissue are critical for a successful outcome and the prevention of severe complications.

Thyroid gland cutaneous fistula secondary to a migratory fish bone: a case report

“…It is known that fish bones may pass through the pharyngeal or esophageal wall spontaneously or during endoscopic manipulation. Even if the fish bone does not migrate out of the pharyngeal or esophageal lumen, the puncture wound created by the foreign body may cause a thyroid abscess [7-9]. In the present case, it is most likely that the fish bone stuck in her cervical esophagus spontaneously migrated out of the lumen anteriorly, penetrated through her esophageal wall and thyroid gland, and reached her anterior cervical hypodermis in the course of one year after she swallowed the fish bone.…”

Fishbone penetration of the thoracic esophagus with prolonged asymptomatic impaction within the aorta

“…2 Although uncommon, fishbone penetration of the cervical esophagus may lead to abscess formation in the deep neck, thyroid, or epidural regions. 2,6,7 Unusual vascular complications, including internal carotid artery puncture and internal jugular vein thrombophlebitis, have been described. 2,8 Fishbone penetration of the thoracic esophagus may cause mediastinitis or abscess, tracheoesophageal fistula, pneumomediastinum, pneumothorax, pericarditis, or cardiac tamponade.…”

Intrathyroid Abscess Formation with Multiple Necrotizing Cervical Lymphadenitis due to Meticillin Resistant Staphylococcus aureus (MRSA); A Case Report with Literature Review

“…The commonest route of infection is probably hematological (3). Other possible causes reported are the direct trauma such as, FNAC, esophageal perforation due to fish bone injury and in children's it is commonly due toanatomical anomalies such as piriform sinus fistula (1,4,5).The acute suppurative thyroiditis now rarely progress to thyroid abscess formation due to widespread use of antibiotics (6). The hemorrhage in to a thyroid cyst leading to secondary infection is a possible cause for the intrathyroid abscess formation.…”