Medline ® Abstracts for References 1,2
of 'Suppurative thyroiditis in children and adolescents'
Diagnosis and Management of Infectious Thyroiditis.
Shah SS, Baum SG
Curr Infect Dis Rep. 2000;2(2):147.
A broad range of disorders can cause inflammation of the thyroid gland. True thyroid infections are rare and can result from a variety of microorganisms, of which bacteria are the most common. Other rarer pathogens include fungi, parasites, and viruses. Gram-positive bacteria, especially staphylococci, predominate as causative agents in adults and children. In immunocompromised patients, opportunistic pathogens have been isolated. Most infections in adults occur as a result of hematogenous or lymphatic seeding of the thyroid gland. In children, congenital anomalies can lead to thyroid infection and require surgical correction to prevent recurrence. Fine-needle aspiration of the thyroid is usually required to identify the infecting agent, and prolonged antimicrobial therapy with or without surgical drainage is the cornerstone of management. This review outlines the pathogenesis, microbiology, diagnosis, and management of infectious thyroiditis in adults and children and compares this disorder with other, more common causes of thyroid inflammation.
Division of Infectious Diseases, Department of Medicine, Beth Israel Medical Center, 350 East 17th Street, 20 Baird Hall, New York, NY 10003, USA. E-mail: firstname.lastname@example.org
Acute bacterial suppurative thyroiditis: a clinical review and expert opinion.
Paes JE, Burman KD, Cohen J, Franklyn J, McHenry CR, Shoham S, Kloos RT
BACKGROUND: Acute suppurative thyroiditis (AST) resulting from a bacterial infection is an infrequent but potentially life-threatening endocrine emergency. Traditional management of this disease has been surgery in conjunction with targeted antibiotic therapy. Recent nonrandomized reports of small series have demonstrated good outcomes using less invasive approaches. No randomized clinical trials have been performed. Here, we provide a review of the literature and an approach to this problem based on expert opinion.
METHODS: The literature was reviewed utilizing PubMed, and a representative case of AST was presented to a panel of experts. Endocrinology, surgery, and infectious disease experts responded to a series of questions regarding diagnosis, management, prognosis, and harm.
RESULTS: Combining a broad spectrum of clinical expertise and the published literature, the authors suggest a clinical algorithm as a guide to management, addressing both diagnosis and acute and long-term management.
CONCLUSIONS: Published studies indicate a trend toward less invasive management during active inflammation and infection and regarding definite therapy. Remaining questions are presented to foster an evidence-based approach to this disease. Ideally, future randomized, controlled trials will provide data to improve the therapy and outcome of AST.
Endocrinology, Diabetes, and Metabolism Feedback Consulting, LLC and Westerville Medical Associates Central Ohio Primary Care Physicians, Inc., Westerville, Ohio 43081, USA. email@example.com