Acute Suppurative Thyroiditis as Invasive Klebsiella Pneumoniae Syndrome

Yi-Ting Tsai ； Li-Nien Tseng ； Shih-Yi Lin ； Wayne H-H Sheu

《Formosan Journal of Endocrinology and Metabolism》 2卷4期 (2011/10) Pp. 89-96

https://doi.org/10.6856/FJEM.201110_2(4).0001

摘要

Acute suppurative thyroiditis is rare as a result of the resistance of the thyroid gland to local infection. Causative organisms been reported include bacteria, fungus, and mycobacterium. Klebsiella pneumoniae thyroid abscess is unusual. Most of these cases were associated with diabetes mellitus or alcoholism. Invasive Klebsiella pneumoniae syndrome with the initial presentation of thyroid abscess had never been reported. Herein, we reported a 62-year-old woman who denied any systemic disease in the past but having non-functioning thyroid goiter over right lobe for more than a decade presented to our hospital as concomitant thyroid abscess, bacteremia, and liver abscess. Klebsiella pneumoniae was cultured from blood sample and pus from thyroid abscess. Subtype study for the pathogen revealed hypermucoviscosity phenotype, K2 capsule, and rmpA-positive genotype, which is commonly seen in the ＂Invasive Klebsiella Pneumoniae Syndrome＂ in Taiwan. She was neither a diabetic patient nor an alcoholic. Barium esophagogram and head-and-neck computed tomography disclosed no pyriform sinus fistula. The patient was successfully treated with antibiotic and repeated aspiration for thyroid abscess following elective right thyroidectomy.

關鍵字

Acute suppurative thyroiditis ； Klebsiella pneumoniae ； invasive syndrome ； hypermucoviscosity phenotype ； magA genotype ； rmpA genotype