年轻健康女性化脓性甲状腺炎引起的可逆性甲状腺毒症

Q3 Medicine
European journal of case reports in internal medicine Pub Date : 2025-03-10 eCollection Date: 2025-01-01 DOI:10.12890/2025_005101
Begüm Süeda Sert, Roderick F A Tummers-de Lind van Wijngaarden, Jacqueline Buijs
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引用次数: 0

摘要

简介:急性化脓性甲状腺炎是一种甲状腺的细菌感染。潜在的危险因素是免疫功能低下或存在预先存在的甲状腺疾病。急性化脓性甲状腺炎可能并发脓肿形成和/或甲状腺毒症,这两种情况都是罕见的但可能危及生命的并发症。病例描述:我们描述了一个22岁健康女性的急性化脓性甲状腺炎继发于扁桃体炎,由于脓肿形成而表现为甲状腺毒症。她主诉有心悸、发热、极度流涎、吞咽困难、颈部疼痛和肿胀。进一步分析显示窦性心动过速,高炎症参数,甲状腺毒症的临床和生化征象。计算机断层扫描显示甲状腺左叶脓肿形成,延伸到咽后间隙,气管偏离到对侧。血培养星座链球菌和中间普雷沃氏菌阳性。患者接受抗生素治疗,并进行手术切除和脓肿引流,恢复良好。对症状性甲状腺毒症给予美托洛尔治疗。中间芽胞杆菌以前没有涉及引起急性细菌性甲状腺炎。结论:健康青年可发生急性化脓性甲状腺炎,无易感因素。伴发甲状腺毒症很少见,但诊断很重要。细菌性甲状腺炎可能是原发性甲状腺感染,也可能是严重扁桃体炎的继发并发症。早期识别和治疗对于降低总体死亡率和发病率以及预防并发症的发生具有重要意义。学习要点:化脓性甲状腺炎可导致明显但潜在可逆的甲状腺毒症。细菌性甲状腺炎可发生在健康的年轻人中,尽管免疫功能低下的患者和解剖变异的患者更容易受到影响。急性化脓性甲状腺炎通常伴有甲状腺功能正常。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reversible Thyrotoxicosis Caused by Suppurative Thyroiditis in a Young Healthy Woman.

Introduction: Acute suppurative thyroiditis is a bacterial infection of the thyroid gland. Potential risk factors are an immunocompromised state or the presence of pre-existing thyroid disease. Acute suppurative thyroiditis may be complicated by abscess formation and/or thyrotoxicosis, which are both rare but potentially life-threatening complications.

Case description: We describe a case of acute suppurative thyroiditis secondary to tonsillitis in a 22-year-old healthy female presenting with thyrotoxicosis due to abscess formation. She presented with complaints of palpitations, fever, extreme salivation, dysphagia, pain and swelling of the neck. Further analysis revealed a sinus tachycardia, high inflammatory parameters, and clinical and biochemical signs of thyrotoxicosis. Computed tomography showed abscess formation in the left lobe of the thyroid gland with extension to the retropharyngeal space and deviation of the trachea to the contralateral side. Blood cultures were positive for Streptococcus constellatus and Prevotella intermedia. The patient was treated with antibiotics and underwent an operative excision and drainage of the abscess and recovered well. Symptomatic thyrotoxicosis was treated with metoprolol. P. intermedia has not previously been implicated in causing acute bacterial thyroiditis.

Conclusion: Acute suppurative thyroiditis may occur in healthy young adults without any predisposing factors. Concomitant thyrotoxicosis is rare, but important to diagnose. Bacterial thyroiditis may be either a primary thyroid infection or a secondary complication of a severe tonsillitis. Early recognition and treatment are of great importance to reduce overall mortality and morbidity, and to prevent the development of complications.

Learning points: Suppurative thyroiditis can lead to overt but potentially reversible thyrotoxicosis.Bacterial thyroiditis can occur in healthy young adults, although immune compromised patients and patients with anatomical variants are more susceptible.Acute suppurative thyroiditis is usually associated with a euthyroid state.

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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
166
审稿时长
8 weeks
期刊介绍: The European Journal of Case Reports in Internal Medicine is an official journal of the European Federation of Internal Medicine (EFIM), representing 35 national societies from 33 European countries. The Journal''s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors). The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.
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