Ultrasound-Guided Drainage via Thyroid Catheterization for Acute Suppurative Thyroiditis: A Case Report.

Abstract

Background: Acute suppurative thyroiditis (AST) is a rare but potentially life-threatening infection of the thyroid gland that requires prompt diagnosis and management. While antibiotic therapy remains the cornerstone of treatment, surgical intervention is often necessary in cases complicated by abscess formation. Minimally invasive approaches have emerged as alternative strategies.

Case presentation: A 49-year-old woman with no significant past medical history presented with a rapidly enlarging painful neck mass, dysphagia, and radiating pain. Initial laboratory findings demonstrated suppressed thyroid-stimulating hormone (TSH) and elevated free thyroxine (FT4), accompanied by elevated inflammatory markers, leading to an initial misdiagnosis of subacute thyroiditis. However, persistent and worsening symptoms prompted further evaluation. Ultrasonography (USG) and contrast-enhanced computed tomography (CT) revealed a large abscess involving the left thyroid lobe. Fine-needle aspiration confirmed AST. The patient was treated with intravenous antibiotics and underwent ultrasound-guided catheter drainage, with approximately 14 mL of pus initially evacuated. She showed rapid clinical improvement, and follow-up imaging confirmed resolution of the abscess with normalization of thyroid function.

Conclusion: This case highlights the importance of distinguishing AST from other causes of thyrotoxicosis. Ultrasound-guided catheter drainage may represent an effective and minimally invasive alternative to conventional surgical management, particularly in patients with large or deep thyroid abscesses.