A Case of Deep Neck Abscess Initially Diagnosed as Subacute Thyroiditis
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- Yamamoto Junpei
- Kanazawa Medical University
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- Kumai Masami
- Kanazawa Medical University
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- Miwa Takaki
- Kanazawa Medical University
Bibliographic Information
- Other Title
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- 亜急性甲状腺炎との鑑別を要した深頸部膿瘍例
- アキュウセイ コウジョウセンエン ト ノ カンベツ オ ヨウシタ シンケイブ ノウヨウレイ
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Abstract
<p>Various factors cause deep neck abscesses. Severe cases can develop the complication of internal jugular vein thrombosis. Acute suppurative thyroiditis is one of the most common causes of deep neck abscess. Most cases arise from a hypopharyngeal pyriform sinus fistula, and the abscess is often on the left side of the neck. We report a case of acute suppurative thyroiditis developing from the right lobe of the thyroid that was complicated by internal jugular vein thrombosis.</p><p>A 44-year-old male patient received antibacterial therapy for sore throat, but showed no improvement. He developed swelling and pain in the right anterior neck. He was diagnosed as having subacute thyroiditis at another hospital and treated with steroids. However, his symptoms worsened, and he was referred to our hospital. Ultrasonography and computed tomography (CT) showed an abscess extending outward from the right lobe of the thyroid gland, and an incision was made to drain the pus. We did not find a fistula in the hypopharyngeal pyriform sinus. Culture of the abscess fluid grew Micromonas micros, Fusobacterium nucleatum, and Porphyromonas gingivalis. There were no infected lesions in the teeth or oropharynx. Based on the findings, the patient was suspected as having acute suppurative thyroiditis due to the infection of a hypopharyngeal pyriform sinus fistula. The CT showed a thrombus in the right internal jugular vein, and the patient received anticoagulant therapy for one year. However, the thrombus failed to resolve.</p><p>Acute suppurative thyroiditis and subacute thyroiditis are difficult to differentiate based the symptoms and blood test results alone. When abscess formation is suspected based on the imaging diagnosis, we suggest performing surgical procedures, such as puncture and incision.</p>
Journal
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- Practica Oto-Rhino-Laryngologica
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Practica Oto-Rhino-Laryngologica 116 (5), 487-493, 2023
The Society of Practical Otolaryngology
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Keywords
Details 詳細情報について
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- CRID
- 1390577431256786560
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- NII Book ID
- AN00107089
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- ISSN
- 18844545
- 00326313
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- NDL BIB ID
- 032875003
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
- Crossref
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- Abstract License Flag
- Disallowed