A person has fever & pain in thyroid gland. True statement is/are
Acute (Suppurative) Thyroiditis Acute thyroiditis is rare and due to Suppurative infection of the thyroid More common in children and often preceeded by an upper respiratory tract infection or otitis media Etiology Thyroid gland is inherently resistant to infection due to its extensive blood & lymphatic supply, high iodide content and fibrous capsule Infectious agents can seed thyroid Via Hematogenous or lymphatic route. Via direct spread from persistent pyriform sinus fistula or thyroglossal duct cysts As a result of penetrating trauma Due to immunosuppression Streptococcus & Anaerobes account for about 70% of cases In children & yound Adults, MC cause is presence of a pyriform sinus (remnant of the fouh Brachial pouch that connects the oropharynx with thyroid), such sinuses are Predominantly left sided Long-standing goiter and degeneration in thyroid malignancy are risk factors in elderly Clinical features Thyroid pain, often referred to the throat or ears, and a small, tender goiter Fever, dysphagia and erythema over the thyroid Systemic symptoms of a febrile illness and Lymphadenopathy Complications such as systemic sepsis, tracheal or esophageal rupture, jugular vein thrombosis, laryngeal choroiditis and perichondritis or sympathetic trunk paralysis may also occur Diagnosis ESR and WBC count are usually increased, but thyroid function is normal FNA biopsy shows infiltration by Polymorphonuclear leukocytes Culture of the sample can identify the organism Persistent pyriform sinus fistula should be suspected in children with recurrent acute thyroiditis. A barium swallow demonstrates the Anomalous tract with 80% sensitivity Treatments Parenteral antibiotics and drainage of abscesses Patients with pyriform sinus fistula require complete resection of the sinus tract, including the area of the thyroid where the tract terminates, to prevent recurrence Ref: schwaz's principle of surgery 10th edition Pgno :1535
T & t level normal
ESR increased
TSH increased
It is due to T.B
Endocrinology and breast