Thyroid aspergillosis: A narrative review
Journal
CMI Communications
Journal Volume
3
Journal Issue
1
Start Page
105177
ISSN
2950-5909
Date Issued
2026-03
Author(s)
Abstract
Background
Thyroid aspergillosis is a rare, severe manifestation of invasive aspergillosis, primarily affecting immunocompromised hosts. The thyroid gland’s inherent defence mechanisms against fungal infection, combined with nonspecific clinical presentations, make timely diagnosis exceptionally challenging and often delay critical treatment.
Objectives
This review aims to delineate the clinical features, highlight the diagnostic difficulties, and describe the therapeutic interventions and outcomes associated with thyroid aspergillosis.
Sources
A literature review was conducted using PubMed from January 1960 to September 2025. Additionally, a new clinical vignette is included to supplement the existing literature.
Content
This review presents a patient with acute myeloid leukaemia and thyroid aspergillosis, demonstrating the application of an aggressive diagnostic approach and the implementation of a successful therapeutic strategy. The review also summarizes previously published reports of thyroid aspergillosis, with comparisons of comorbid conditions, clinical presentations, diagnostic methods, Aspergillus species distribution, and management strategies between survivors and nonsurvivors.
Implications
Thyroid aspergillosis requires a high index of suspicion in at-risk patients, especially those presenting with the clinical triad of fever, local compressive symptoms, and thyrotoxicosis. Early diagnosis through serum galactomannan antigen and direct tissue sampling for histopathology and culture is essential and increases the likelihood of an antemortem diagnosis. Antimould triazoles are the first-line pharmacologic therapy, consistent with invasive aspergillosis guidelines.
Publisher
Elsevier BV
Type
journal article