Acute suppurative thyroiditis is a rare disease because thyroid gland is highly resistant to infection. The most common predisposing factor is the presence of a piriform fistula. We report an unusual case of hyperthyroidism caused by AST.
A 27-year-old woman was admitted to our hospital because she presented a painful swelling in the left thyroid gland with fevers. Laboratory test showed a white leukocyte count of 14 000/μl, a CRP level of 251 mg/l, a thyrotropin level of 0.1 mUI/l, a T4 level of 41 pmol/l. A neck computed tomography scan revealed an abscess in the thyroid gland and the presence of a piriform sinus fistula. After appropriate antibiotic therapy and propanolol administration, the patient underwent fistulectomy and resection of the left upper lobe of her thyroid gland. The thyroid function became normal approximately one month after.
So the clinical feature of thyroid abscess includes hyperthyroidism. It can be evocated before AST because some cases of thyrotoxicosis have been described and can complicated surgery.