Acute suppurative thyroiditis in children

Introduction to acute suppurative thyroiditis in children Thyroiditis (thyroiditis) is a thyroid parenchymal injury caused by various causes of thyroid inflammatory disease, including various types of inflammation and infection of the thyroid gland. In recent years, due to the progress of pathogenesis research and detection methods, the detection rate has increased. Acute suppurative thyroiditis (AST) is rare in pediatrics and may be associated with a complete capsule of the thyroid gland, high iodine content, and abundant blood supply and lymph, which is beneficial for bacterial invasion and growth. basic knowledge The proportion of illness: 0.001% - 0.003% Susceptible people: children Mode of infection: non-infectious Complications: hyperthyroidism

Causes of acute suppurative thyroiditis in children

(1) Causes of the disease

Most of the direct infection of the neck affects the thyroid gland, or the gland is caused by septicemia. The common pathogens are Staphylococcus aureus, Streptococcus or Pneumococci, and Escherichia coli or Aerobacteria are occasionally seen.

(two) pathogenesis

For the characteristic changes of acute inflammation, typical polynuclear leukocytes and lymphocytes infiltrate in the early stage of the lesion, followed by fibrous tissue hyperplasia, or tissue necrosis to form thyroid abscess.

Prevention of acute suppurative thyroiditis in children

Mostly caused by neck infection directly, or caused by sepsis bacteria invading the gland, such as purulent infection in the mouth or neck, the pathogens are staphylococcus, streptococcus and pneumococci, therefore, the mouth or neck should be thoroughly treated in time. The infection of the Ministry can prevent the occurrence of this disease.

Complications of acute suppurative thyroiditis in children Complications

Sometimes due to inflammatory swelling can affect breathing; when thyroid necrosis, thyroxine release, symptoms of hyperthyroidism can occur; at the same time may be accompanied by nearby lymph nodes.

Acute suppurative thyroid symptoms in children Common symptoms Aversion to cold, sore throat, fever, and lymphadenopathy... Swallowing pain, thyroid enlargement, erythrocyte sedimentation rate

The onset is more urgent, the systemic symptoms may have fever, usually at 38 ~ 40 ° C, aversion to cold, sore throat, anterior thyroid gland may have a lump, red, swollen, hot, can be a leaf or two leaves, more violation of the left lobe, It has been reported that 19 of 34 patients have left lobe invasion. When the head is tilted or turned, the pain can be aggravated when swallowing. It can radiate the ear, the occipital part, sometimes affecting the breathing. If there is a feeling of fluctuation in the abscess, when The thyroid gland is in the stage of necrosis, and a large amount of thyroxine is released into the blood, and symptoms of hyperthyroidism may occur, accompanied by swelling and tenderness of nearby lymph nodes.

Examination of acute suppurative thyroiditis in children

1. Blood examination: peripheral blood examination showed a significant increase in white blood cells, increased neutrophil classification, left nucleus and poisoning particles; increased erythrocyte sedimentation rate.

2. Thyroid function test: serum T3, T4 can be increased, TSH is reduced.

3. Pathogen and pathological examination: smear by subcutaneous biopsy, local puncture can be purulent, pathogens can be found, cytological pathology and bacterial culture examination.

4. Thyroid ultrasonography and scanning examination: showing thyroid enlargement, inflammatory changes, radionuclide imaging, if the thyroid parenchymal damage is indicated, especially in the left lobe.

5. Esophageal swallowing examination: All children should be examined for esophageal swallowing, and careful observation of the presence of LPSF, due to local edema in the acute phase, it is often difficult to find the fistula, it is recommended to do this examination after 8 weeks of onset.

Diagnosis and diagnosis of acute suppurative thyroiditis in children

diagnosis

First of all, you should be vigilant about this disease. When the pharyngeal pain, pre-neck mass, or radiation pain, and inflammation manifestations should consider the possibility of the disease, the test can be seen:

1 white blood cells increased, neutral lobes increased, nuclear left shift and poisoning particles.

2 ESR increased.

3 ultrasound can assist in diagnosis.

4 local puncture can be purulent, and the difference between thyroid cancer or thyroid tumor bleeding, normal thyroid function.

The levels of serum T4 and T3 were close to normal or slightly increased, T3U was normal, and iodine absorption rate was normal at 24 hours.

For acute onset, painful neck mass, especially in children with recurrent episodes on the left side, should be suspected of AST, can be used for thyroid ultrasound or radionuclide imaging, especially if the thyroid parenchymal damage is indicated. Leaf involvement, AST diagnosis is basically established, subcutaneous biopsy for smear, cytological pathology and bacterial culture examination is a means of AST diagnosis, therefore, some scholars believe that thyroid ultrasound map with fine needle aspiration is a valuable method for early diagnosis of AST, in addition All children should be examined for esophageal swallowing.

Thyroid function tests seem to be meaningless for diagnosis, as most AST children have normal thyroid function before and after onset.

Differential diagnosis

Different from thyroid cancer or thyroid tumor hemorrhage, AST acute phase needs to be differentiated from other painful thyroid diseases (subacute granulomatous thyroiditis, thyroid nodules, tumor hemorrhage), etc.; still need to be associated with painless thyroid gland after acute phase Disease and neck mass (CLT, cervical lymphadenitis, rib fissure cyst, thyroid sac cyst, etc.) were identified.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.