Clinical characteristics and management of acute suppurative thyroiditis in children
Journal
Journal of the Formosan Medical Association
Journal Volume
101
Journal Issue
7
Pages
468-471
Date Issued
2002
Author(s)
Chang P.
Hsiao P.-H.
Lee J.-S.
Li Y.-W.
Abstract
Background: Acute suppurative thyroiditis is an uncommon disease in children. This paper describes the clinical characteristics and management of children with acute suppurative thyroiditis treated during a 15-year period at National Taiwan University Hospital. Patients and Methods: From 1985 to 2000, acute suppurative thyroiditis was diagnosed in 11 previously healthy children (6 boys, 5 girls) at the Department of Pediatrics. Their mean age at diagnosis was 6.4 ± 4.4 years. Leukocyte count, acute-phase reactants, thyroid function, and thyroid autoantibodies were assessed. Samples were taken by thyroid needle aspiration for cytology study and pus culture. Underlying pyriform sinus fistula (PSF) was demonstrated by barium esophagogram. Results: Leukocytosis was noted in six cases (55%) and acute-phase reactants were elevated in eight cases (73%). Neither thyroid autoantibodies nor thyroid dysfunction was detected in any of the patients. Barium esophagogram detected PSF in eight of 10 patients examined. Five (45%) patients had recurrent suppurative thyroiditis before surgery. Cytology and pus cultures were available for 10 patients. Polymorphonuclear cells were the main findings in the smear from thyroid aspirates. Twenty-two organisms were isolated from six patients (60%). Streptococcus species (45%) and anaerobic organisms (41%) were the most common pathogens isolated. Mixed infection was detected in five of six children who had a causative microorganism identified. The microorganisms were all sensitive to amoxicillin-clavulanate. Conclusion: PSF plays a role in the pathogenesis of acute suppurative thyroiditis in children. Streptococcus species are the most common pathogens in acute suppurative thyroiditis. Our results suggest that amoxicillin-clavulanate is the drug of choice for the treatment of this disease.
SDGs
Other Subjects
amoxicillin plus clavulanic acid; barium; C reactive protein; liothyronine; microsome antibody; thyroglobulin antibody; thyroid antibody; thyrotropin; thyroxine; acute phase response; adolescent; anaerobic bacterium; antibiotic sensitivity; article; bacterium isolation; barium meal; child; clinical article; clinical feature; controlled study; culture technique; cytopathology; drug choice; esophagography; female; human; human cell; human tissue; leukocyte count; leukocytosis; male; mixed infection; needle biopsy; pathogenesis; patient care; polymorphonuclear cell; pus; Streptococcus; Taiwan; thyroid disease; thyroid function; thyroiditis; university hospital; Acute Disease; Adolescent; Amoxicillin-Potassium Clavulanate Combination; Child; Child, Preschool; Female; Fistula; Humans; Infant; Male; Thyroiditis, Suppurative
Type
journal article