Thyroid Tuberculosis in a Child: A Rare Entity

Abstract

Thyroid tuberculosis is a rare disease even in countries where tuberculosis is endemic. Clinically tuberculosis is not often suspected in cases of thyroid nodule or swelling. We report a case of 11 years female child who presented with a thyroid swelling. Fine-needle aspiration cytology revealed caseating epithelioid granulomas and acid fast bacilli. Patient improved with antitubercular drugs. Tuberculosis may be considered as differential diagnosis of thyroid swelling.

Primary thyroid gland tuberculosis: a conundrum in a child

“…8 Since then, there have been many isolated case reports and few case series pertaining to it in the literature. 7,9 The pathogenesis behind the dissemination of tubercle bacilli to the thyroid gland is controversial. It usually occurs in association with tuberculous infection of the other tissues or organs.…”

“…However, the children constitute very small proportion of these cases, with the youngest documented case being that of a 5-month old female infant. 7,8,13 These patients can be asymptomatic or may have an acute or subacute presentations, the duration of which varies from two weeks to one year and has no relationship with the patient's age or sex. The most common symptoms are fatigue, fever, night sweats and weight loss.…”

“…6 This is owing to the bactericidal property of colloid, high vascularity, iodine excess, well-developed capsule, enhanced activity of phagocytes in hyperthyroidism and possible antitubercular roles of thyroid hormone. 7 TB is usually misdiagnosed at such atypical locations as the signs and symptoms are non-specific as well as it can masquerade several other clinical conditions resulting in diagnostic conundrum and unnecessary aggressive therapeutic interventions. One such experience of an extremely rare unsuspected case of primary thyroid gland TB in a 7-year-old female is reported herewith so as to create awareness about this enigmatic entity.…”

Tuberculosis of Thyroid Gland in a Pediatric Patient

“…Tuberculosis of the thyroid gland is rare [1][2][3][4]. Thyroid is perceived to be an organ that is resistant to tuberculosis infection as it has a rich blood supply, high Iodine content and contains colloid which is bactericidal.…”

“…Tuberculosis of the thyroid gland is rare [1][2][3][4]. As a result, when a patient presents with diffuse thyroid enlargement, solitary nodule or a midline swelling, tubercular etiology is never the first diagnosis.…”