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Acute Infectious Thyroiditis: What Patients Need to Know

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Updated June 03, 2014

Woman rubbing sore neck
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The term thyroiditis refers generally to any disorder that involves inflammation of the thyroid. Thyroiditis is typically divided into two broad categories -- painless and painful -- that involve the level of pain they cause to patients.

Among the category of painful types of thyroiditis is a form known as acute infectious thyroiditis.

Acute infectious thyroiditis usually occurs in patients who have a weakened immune system. It's often caused by a bacterial infection -- such as staph or strep bacteria -- that then leads to an abscess in the thyroid gland.

To learn more about infectious thyroiditis, I reviewed an overview of thyroiditis on UpToDate -- an electronic reference used by many physicians and patients that presents in-depth medical information.

"Acute infectious thyroiditis is characterized by the sudden onset of neck pain and tenderness that is usually unilateral and is accompanied by fever, chills and other symptoms and signs of infection. Most patients have a unilateral neck mass, which may be fluctuant. Acute neck pain and tenderness and a thyroid mass may also be caused by hemorrhage into a thyroid nodule. Thyroid function in patients with acute infectious thyroiditis is usually normal.

"A patient who has a painful tender thyroid mass should be evaluated immediately with clinical examination and needle aspiration of the mass, followed by drainage and antibiotic therapy according to the results of studies of the fluid obtained from the neck mass or of blood or other cultures. Ultrasonography or other imaging studies should be performed to confirm the presence of a single abscess. In most instances, rapid diagnosis and treatment is required. Infrequently, surgical drainage or removal is required in patients who do not respond to percutaneous drainage and systemic antibiotic therapy. It is important to differentiate acute infectious thyroiditis from subacute thyroiditis.

Symptoms of Acute Infectious Thyroiditis

If you are experiencing acute infectious thyroiditis, the symptoms include:
  • Rapid onset of pain and tenderness in one side of the neck
  • Fever and chills
  • An enlargement in the neck area, or a movable lump in the neck that you can feel
If you have these symptom, you'll want to see your physician as soon as possible for evaluation and treatment.

Diagnosing and Treating Acute Infectious Thyroiditis

If your doctor suspects acute infectious thyroiditis, a number of steps will be taken, including:
  • Ultrasound or imaging of the thyroid, to determine if there is one or more abscesses to be treated
  • Fine needle aspiration (FNA) of the mass in your thyroid. The involves withdrawing some of the fluid or material from the mass to evaluate it. The sample will be cultured to look for infection.
  • Drainage of the mass or lump
  • Blood tests to evaluate thyroid function, and look for signs of infection
  • Prescription of an antibiotic medicine that will treat the particular type of infection
While most patients respond to drainage and antibiotic treatment, in rare cases, surgical drainage or removal may be needed.

Want to learn more? See UpToDate's topic, "Overview of thyroiditis," for additional in-depth, medical information

Source:

Burman, Kenneth. Ross, Douglas. Martin, Kathryn. "Overview of thyroiditis." UpToDate. Accessed: August 22, 2008.

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