[Clinical study of 15 children with acute suppurative thyroiditis].

Abstract

From 1969 to 1990, 15 children with acute suppurative thyroiditis (AST) were diagnosed in our hospital. Their clinical, laboratory and radiologic findings were reviewed. The characteristic features were as follows: 1) Males to female ratio was 1.5:1. 2) The ages at diagnosis ranged from 3 to 14 years, with a mean age of 6 years. 3) A painful, tender mass in the anterior neck was detected in all cases and fever was detected in 10 cases (67%). 4) The left lobe of the thyroid was affected in 11 cases (73%), whereas the right lobe was affected in the remaining 4 cases. No cases was bilateral. 5) Five cases (33%) were found to be recurrent. 6) Eight pathogenic organisms were identified on culture from 7 cases; among them 3 were due to anaerobic pathogen. 7) Leukocytosis was increased and acute-phase reactant tests were positive in most cases. 8) Thyroid function was found to be normal in all 9 cases examined. 9) Radiologic studies, which included radionuclide thyroid scan, ultrasonography, computed tomography and barium esophagogram, were very helpful for the diagnosis of AST. 10) A barium esophagogram was performed in 9 cases and a fistula originating from the pyriform sinus was found in 4 cases (44%). 11) Three cases (20%) had the complete removal of the fistula as a permanent cure. This report summarizes the clinical features of 15 children with acute suppurative thyroiditis diagnosed in our hospital during the past twenty years.