Impaired vocal cord mobility in the setting of acute suppurative thyroiditis

Abstract

Background Acute suppurative thyroiditis is an increasingly rare entity, accounting for less than 0.1% of thyroid surgery. This is the first report in the literature of acute thyroiditis causing a unilateral reversible vocal cord paralysis. Methods A 41‐year old woman was initially seen with a unilateral vocal cord paralysis resulting from acute suppurative thyroiditis. Results The vocal cord paralysis resolved following surgical drainage of the thyroid abscess and treatment with intravenous antibiotics. Conclusions We present this case to emphasize the need for a complete and thorough head and neck exam including preoperative documentation of vocal cord mobility. © 1997 John Wiley & Sons, Inc. Head Neck 19: 235–237, 1997.

Salmonella thyroid abscess in a pre-existing multinodular goitre: rare clinical entity with review of literature

“…Infrequently the condition may present with vocal cord paralysis. 9 A differential diagnosis which should be considered in these patients would be viral thyroiditis, and more often is preceded by an attack of URTI. Painful thyroid may also be seen in neoplasms, amyloidosis, amiodarone associated thyrotoxicosis, intranodular hemorrhage, Grave's disease, and infarction of a thyroid nodule.…”

“…2,12,13 Suppurative thyroiditis can lead to destruction of the thyroid or parathyroid glands, internal jugular vein thrombophlebitis, vocal cord palsy, abscess rupture or fistula formation into the esophagus or trachea, local or hematologic spread to other organs and sepsis. 2,[8][9][10] Surgery with excision of the affected lobe or debridement, resection of a fistulous connection if present would be the primary modality of treatment. This is combined with use of appropriate antibiotics against the causative organism.…”

Acute Thyroid Abscess Secondary to Oesophageal Perforation

“…Boyd et al 4 proposed that the abscess merely be incised and drained to avoid performing a thyroidectomy in already inflamed tissue. One disadvantage of this technique is that it leaves an inflamed thyroid gland in close proximity to the source(s) of infection.…”

Acute Suppurative Klebsiella Thyroiditis: A Case Report

“…Thyroid abscess accounted for only 0.1% of thyroid surgery in the pre-antibiotic era. Nowadays, when the use of antibiotics is widespread, the incidence is much lower (1,2). The thyroid gland is rarely infected because of its complete fibrous encapsulation, rich vascular supply and lymphatic drainage, and high iodine concentration that inhibits bacterial growth (3).…”

“…The most important causal micro-organisms are bacteria, although fungi have been involved in immunodepressed subjects (4). Pre-existing thyroid gland pathology, a retained foreign body and local anatomic abnormalities, such as pyriform sinus fistula (PSF) and thyroglossal duct, are predisposing factors for acute suppurative thyroiditis (1,2,4,5,9). Thyroid abscess mostly develops from AST in patients with PSF.…”