Pyogenic thyroiditis is often caused by a bacterial or fungal infection and can cause serious symptoms and complications. Therefore, it is important to recognize the disease for timely diagnosis and treatment to prevent complications and ensure the overall health of the patient.
What is pyogenic thyroiditis?
Pyogenic thyroiditis is also known as acute suppurative thyroiditis or acute pyogenic thyroiditis. This is a disease state that occurs when the thyroid gland is attacked and destroyed by bacteria or parasites, causing pus to accumulate in the thyroid gland. Although rare, pyogenic thyroiditis is a dangerous condition that can be life-threatening.
Purulent thyroiditis is usually caused by bacteria or parasites.
The thyroid gland is a part of the body that is “safely” protected by many surrounding structures. It receives abundant blood flow, contains high concentrations of iodine and has a good lymphocyte conduction mechanism… Thanks to these properties, the thyroid gland is able to resist most infections. In general, the thyroid gland has good “immune” capabilities. However, in some cases, especially in children, due to defects or fistulas in the pear-shaped shape from the pyriform sinus on the left side of the thyroid gland, agents such as bacteria or parasites can penetrate the thyroid gland through this fistula and cause pus accumulation.
Although purulent thyroiditis is a rare form of thyroiditis, the disease tends to increase due to the increasingly common immunodeficiency. Children account for 92% of cases of purulent thyroiditis. Only 8% of cases are recorded as adults with this disease.
Causes of purulent thyroiditis
Purulent thyroiditis has many causes. Most cases are caused by bacterial infections, while some are caused by fungal and parasitic infections.
Many types of bacteria have been identified as causing purulent thyroiditis. Among these, Staphylococcus aureus and Streptococcus species are the most common. In addition, there are cases caused by Mycobacterium tuberculosis (often associated with HIV), Treponema pallidum (causing syphilis), Pasteurella, Multocida, Porphyromonas, Eikenella, Brucellosis, Candida, Salmonella, and anaerobic bacteria such as Bacteroides fragilis, Escherichia coli, and Klebsiella.
In addition, there are a number of risk factors that increase the risk of acute purulent thyroiditis. These include the use of intravenous drugs, as it can facilitate the bacteria to enter the body easily. People with weakened immune systems due to illness, taking immunosuppressants, or undergoing chemotherapy for cancer are also at higher risk. In addition, women with breast cancer are also at risk. Finally, fall and winter are often associated with a higher risk of respiratory infections.
Symptoms of suppurative thyroiditis
People with suppurative thyroiditis often have the following clinical signs:
- High fever or chills;
- Pain in the neck and throat;
- Difficulty swallowing and pain when swallowing;
- Difficulty speaking.
Purulent thyroiditis often causes sore throat.
When performing tests and imaging tests, the following symptoms are often detected in patients:
- Increased levels of C-reactive protein (CRP) or pro-calcitonin.
- Increased white blood cell count.
- Increased erythrocyte sedimentation rate.
- When using ultrasound or CT scan, the thyroid gland often appears to have pressure points.
- The pathogenic bacteria are often detected in secretions taken from the thyroid gland.
Complications of purulent thyroiditis
Acute purulent thyroiditis can lead to a number of complications, the most common of which is abscess, a local infection that is difficult to treat with antibiotics. In addition, there are a number of other potential complications, including:
Systemic infection
This is a rare complication of acute infectious thyroiditis, in which bacteria can spread to other areas of the body. Leakage of an abscess from the thyroid gland to neighboring areas is a rare but dangerous complication. If the abscess is not promptly drained, it can spread to nearby areas causing infection in the neck, throat, and even into the chest. It is worth noting that when there is an abscess in the head and neck area, the rate of spread of abscess and pus will be much faster than in other areas, because the structure of this area is quite vulnerable.
In particular, if the patient has underlying diseases such as diabetes, kidney failure due to drugs, or immunodeficiency, the mortality rate will be very high. Moreover, infection from the thyroid gland can spread through the circulatory system causing blood poisoning and septic shock.
Thyroid bleeding
Thyroiditis due to infection can lead to complications of bleeding, causing swelling and can affect the respiratory system and damage the thyroid gland.
Thyroid dysfunction
Although rare, long-term thyroid dysfunction can occur after the infection is completely treated. The most common thyroid dysfunction is permanent hypothyroidism, which occurs in severe cases of thyroiditis causing almost complete damage and necrosis of thyroid tissue, requiring lifelong treatment with thyroid hormone replacement.
Purulent thyroiditis can easily lead to complications such as thyroid damage.
Treatment of suppurative thyroiditis
The use of appropriate systemic antibiotics based on bacterial sensitivity is very important, especially in severe cases. In cases where there is no information on bacterial sensitivity, the doctor may choose to use antibiotics that are sensitive to bacteria in the oral cavity, such as high-dose penicillin G or ampicillin, which can be combined with metronidazole or clindamycin if there is suspicion of anaerobic infection.
For severe infections or suspected infections from distant sources, antibiotics that are sensitive to antibiotic-resistant staphylococci and broad-spectrum antibiotics such as third-generation cephalosporins should be selected.
The above is some information about suppurative thyroiditis. From the above information, it can be seen that this is a worrying disease, so maintain a strong immune system through a healthy diet, regular exercise and stress reduction to help reduce the risk of suppurative thyroiditis.
