Acute Suppurative Thyroiditis

Acute suppurative thyroiditis is a medical emergency that usually presents with anterior neck pain, fever, and dysphagia and can lead to airway obstruction. Thyroid infection is rare, and an underlying immune deficiency or thyroid abnormality is present in most cases. The majority of immunocompetent patients will have a pyriform sinus fistula. Differentiating acute suppurative thyroiditis from painful subacute thyroiditis or invasive head and neck infections usually requires diagnostic imaging with CT or ultrasound. In certain instances, tissue histology obtained by fine needle aspiration may be required to definitively diagnose acute suppurative thyroiditis. Obtaining cultures by aspiration, surgery, or percutaneous drainage is required to guide antibiotic therapy. The majority of acute suppurative thyroiditis cases are caused by Staphylococcus aureus and Streptococcus species. Acute suppurative thyroiditis should be treated urgently with antibiotics and abscess drainage.