Acute suppurative thyroiditis after fine needle aspiration. Case report and literature review

The thyroid gland is remarkably resistant to infectious agents owing to several protective mechanisms. Acute suppurative thyroiditis after fine needle aspiration is very rare. Many authors has proposed a second fine needle aspiration with drainage, combined with culture and appropriate antibiotic therapy. We report a single case of acute suppurative thyroiditis after fine needle aspiration treated successfully without requiring additional invasive approaches. A 39-year-old female patient in therapy with immunosuppressive drugs for psoriasis, came to our department with painful cervical swelling, fever, and chills after fine needle aspiration for thyroid cystic nodule. A new one to decide to antibiotic treatment was not carry out. The patient was treated only with empiric antibiotics therapy. Thyroidectomy was not carried out because it was not surgical indication. In the case of thyroid abscess immediate treatment with empirical antibiotic therapy is recommended. We believe that if the regression of local signs and symptoms is immediate with empirical antibiotic therapy, percutaneous drainage or other invasive procedures can be avoided.