The role of ultrasound and oesophagography in the management of acute suppurative thyroiditis in children associated with congenital pyriform fossa sinus

Ahuja, Anil T.; Griffiths, J; Roebuck, Derek J.; Loftus, William K.; Lau, KCH; Yeung, Chung Kwong; Metreweli, C.

doi:10.1016/s0009-9260(98)80102-5

Cited by 37 publications

(18 citation statements)

References 12 publications

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“…Sonography has been reported to be a good modality for detection of fistulas [9,10], but there have been no reports of neonatal cases in which sonographic findings were important for detection of a fistula. In this case series, we examined neck cystic lesions in five neonatal cases to detect pyriform sinus fistulas using various combinations of sonography, barium esophagography, CT, and MRI.…”

Section: Discussionmentioning

confidence: 99%

“…A definitive diagnosis requires detection of the fistula, which originates from the pyriform sinus and extends to the cystic lesion [5][6][7][8]. Various modalities, including sonography, barium esophagography, computed tomography (CT), magnetic resonance imaging (MRI), and direct infusion of contrast agent into the cystic lesion, can be used to detect fistulas [5,7,9,10]. Sonography has been reported to be useful for detecting fistulas, but there have been no reports of neonatal cases in which sonography was able to detect fistulas that were not detected by other modalities.…”

Section: Introductionmentioning

confidence: 99%

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Five neonatal cases of pyriform sinus fistula with cervical cystic lesion: a comparison between sonography and other modalities

et al. 2015

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Pyriform sinus fistulas are an unusual cause of neck cystic lesions in neonates. A definitive diagnosis requires detection of the fistula, which originates from the pyriform sinus and extends to the cystic lesion. Sonography has been reported to be useful for detecting fistulas. However, there have been no reports of neonatal cases in which sonography could detect fistulas not detected by other modalities, such as barium esophagography, computed tomography (CT), or magnetic resonance imaging (MRI). We describe five neonatal patients with pyriform sinus fistula-appearing cervical cystic lesions. All patients were examined by sonography; of these, three patients were also examined by barium esophagography, two by CT, and one by MRI. The fistula was detected by sonography but not CT in one patient and by barium esophagography but not MRI in one. Two patients whose fistulas were detected by sonography had an oval-shaped and relatively small cystic lesion. One patient whose fistula could be detected only by barium esophagography had a relatively large cystic lesion. In two patients, whose fistulas were not detected by sonography or barium esophagography, sonography revealed air bubbles within the cystic lesions, and a pyriform sinus fistula was suspected. Without requiring ionizing radiation, sonography was thus useful in diagnosing pyriform sinus fistula-appearing cervical cystic lesions in neonatal cases. On the other hand, in two patients whose fistulas were not detected by sonography, the shape of the cystic lesion was polygonal or multicystic. In two of three patients with infectious signs, a fistula could not be detected. The shape and size of the cystic lesion and the presence of infectious signs may be important factors for detecting fistulas.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Five neonatal cases of pyriform sinus fistula with cervical cystic lesion: a comparison between sonography and other modalities

et al. 2015

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“…Therefore, approximately 90% of cases involve the left thyroid lobe, only 6% involve the right lobe, and 2% are bilateral (3,(13)(14)(15)(16)(17)(18)(19). In other cases, the presence of an autoimmune disease or an immunocompromised host has been reported as the basis for infectious diseases of the thyroid gland (20).…”

Section: Discussionmentioning

confidence: 99%

Right-Sided Acute Suppurative Thyroiditis Caused by Infectious Endocarditis

et al. 2011

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Acute suppurative thyroiditis is a rare disorder that is mostly found in the left lobe of the thyroid gland of children due to congenital patency of the pyriform sinus fistula. Here, we report a 61-year-old man with acute right-sided suppurative thyroiditis without pyriform sinus fistula. He also showed infectious hip arthritis, spondylitis and Roth's spots. He presented with heart failure and was diagnosed with infectious endocarditis by sequential transesophageal echocardiography. A replacement with a prosthetic valve was performed and cured him. It is important to recognize that infectious endocarditis can be a focus of acute suppurative thyroiditis.

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“…Microbes can also spread from adjacent sites of infection (ie, esophagus, oropharynx, and middle ear) along and through fascial planes, although this occurs less often because the thyroid is encapsulated by a fibrous sheath [11]. Congenital anomalies, such as a persistent thyroglossal duct or a pyriform sinus fistula (an embryonic remnant of the third or fourth branchial pouch), provide direct communication to the thyroid gland and can become infected and thereby facilitate local spread of organisms to cause suppurative, often recurrent, thyroiditis, particularly in children [12]. A history of antecedent pharyngitis or other upper respiratory tract infection is often present in both pediatric and adult cases [6,11].…”

Section: Pathogenesis and Epidemiologymentioning

confidence: 99%

Diagnosis and management of infectious thyroiditis

Shah

Baum

2000

Curr Infect Dis Rep

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A broad range of disorders can cause inflammation of the thyroid gland. True thyroid infections are rare and can result from a variety of microorganisms, of which bacteria are the most common. Other rarer pathogens include fungi, parasites, and viruses. Gram-positive bacteria, especially staphylococci, predominate as causative agents in adults and children. In immunocompromised patients, opportunistic pathogens have been isolated. Most infections in adults occur as a result of hematogenous or lymphatic seeding of the thyroid gland. In children, congenital anomalies can lead to thyroid infection and require surgical correction to prevent recurrence. Fine-needle aspiration of the thyroid is usually required to identify the infecting agent, and prolonged antimicrobial therapy with or without surgical drainage is the cornerstone of management. This review outlines the pathogenesis, microbiology, diagnosis, and management of infectious thyroiditis in adults and children and compares this disorder with other, more common causes of thyroid inflammation.

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The role of ultrasound and oesophagography in the management of acute suppurative thyroiditis in children associated with congenital pyriform fossa sinus

Cited by 37 publications

References 12 publications

Five neonatal cases of pyriform sinus fistula with cervical cystic lesion: a comparison between sonography and other modalities

Five neonatal cases of pyriform sinus fistula with cervical cystic lesion: a comparison between sonography and other modalities

Right-Sided Acute Suppurative Thyroiditis Caused by Infectious Endocarditis

Diagnosis and management of infectious thyroiditis

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