AspergillusThyroiditis after Allogeneic Hematopoietic Stem Cell Transplantation

Abstract

Aspergillus thyroiditis is a rare disorder detected in immunocompromised patients during disseminated infections. Early management is essential to prevent high mortality. A 61-year-old allogeneic stem cell male recipient presented with painful thyroid nodular enlargement. He had low TSH and low free T4 levels. The thyroid ultrasound showed a hypoechoic nodule; biopsy indicated suppurative Aspergillus thyroiditis. He was successfully treated by amphotericin B.

Methicillin-Sensitive Staphylococcus aureus Suppurative Thyroiditis with Thyrotoxicosis

“…Moreover, AST usually occurs in those who have underlying thyroid pathology, such as neoplastic thyroid nodules, Hashimoto's thyroiditis, subacute thyroiditis, multinodular goiters, or penetrating trauma to the thyroid gland [ 2 ]. Cases reported in older adults were associated with degrees of immunocompromisation, such as infection with HIV [ 4 ], renal failure requiring hemodialysis [ 5 ], or reception of stem cell transplant [ 6 ]. Symptoms of AST include fever, dysphagia, and tender neck mass.…”

An Unusual Case of Neck Swelling

“…Immunosuppressed patients have also been documented to have Pneumocystis jiroveci, Nocardia species, Aspergillus, and other rare fungi as the causative agent. [6,7,8,9] One case report attributed AST secondary to a urinary tract infection by E. coli. [10] In this case, the patients Hemoglobin A1c was 13.1%.…”

A suppurative thyroiditis and perineal subcutaneous abscess related with aspergillus fumigatus: a case report and literature review

“…Most of the aspergillus thyroiditis cases were diagnosed at the age of 11–30 year old (12 cases) [7–18] and 7 cases were over 60 years old [3, 19–24]. 13 of 29 patients had primary infection in lung or airway (44.8%) and primary aspergillus thyroiditis was reported in 12 cases.…”

“…13 of 29 patients had primary infection in lung or airway (44.8%) and primary aspergillus thyroiditis was reported in 12 cases. Except for 1 case [25], all the other patients had critical underlying diseases: 9 cases (29.0%) of organ transplantations [7, 10, 15, 19, 21, 22, 26–29]; 11 cases (35.5%) of hematologic malignancy diseases including 2 cases of acute myelocytic leukemia (AML) (6.5%) [6, 7], 2 cases of acute lymphocytic leukemia (ALL) (6.5%) [17, 30], 3 cases of non-Hodgkin’s lymphoma (NHL) (9.7%) [11, 19, 31] and 4 cases (12.9%) of myelodysplastic syndrome (MDS) [14, 20, 31, 32]; 1 case suffered the acquired immune deficiency syndrome (AIDS) [33]; Another comorbidity was SLE in 5 patients (16.1%) [8, 12, 13, 16, 18] (Table 1).…”

“…Most aspergillus thyroiditis cases showed signs in diagnostic imaging, but sonography and computed tomography presented nonspecific changes of thyroid gland. Histological tests (15 cases) and fine needle aspiration (15 cases) led to frequent diagnoses, but screening for aspergillus by detection of galactomannan was helpful in only 5 reports [17, 19, 21, 26, 29] (Table 1).…”