Acute Suppurative Thyroiditis Caused by Propionibacterium Acnes After Fine Needle Aspiration

I-Weng Yen ； Shyang-Rong Shih ； Wan-Chen Wu ； Chih-Yuan Wang

《Formosan Journal of Endocrinology and Metabolism》 13卷1期 (2022/06) Pp. 57-62

https://doi.org/10.6856/FJEM.202206_13(1).0008

摘要

Background: Acute suppurative thyroiditis (AST) is a rare, but potentially life-threating endocrine emergency and has been reported after fine needle aspiration (FNA). Method: Here we report a case of AST with colloid nodular goiter one month after FNA. Result: This 54-year-old gentleman presented fever with tenderness and redness over thyroid area with elevated CRP. Before, he received FNA of thyroid one month ago. Thyroid sonography showed multiple hypoechoic lesion with heterogeneous content and pus-like dark-brown material was aspirated and culture rapidly revealed Propionibacterium acnes. Due to certain tracheal compressive effect with swollen goiter change, he was suggested right total thyroidectomy immediately. Propionibacterium acnes and other Propionibacterium species are non-spore forming, anaerobic gram-positive bacilli, which normally inhabit in the mouth and upper respiratory tract. Such bacteria have been identified as pathogen related to infections at multiple sites. Hematogenous origin from mouth due to dental caries was highly suspected. Conclusion: Although acute suppurative thyroiditis is a rare complication following FNA, it may cause serious symptoms once occur. We report this case to remind the possibility of probable remote infection from oral cavity due to aspiration procedure of colloid cystic goiter.

關鍵字

acute suppurative thyroiditis ； fine needle aspiration ； Propionibacterium acnes