Endocrinol Metab > Volume 27(3); 2012 > Article
Endocrinology and Metabolism 2012;27(3):222-226.
DOI: https://doi.org/10.3803/EnM.2012.27.3.222    Published online September 19, 2012.
A Case of Actinomycotic Thyroiditis in an Adult with Piriform Sinus Fistula.
Hyun Ju Choi, Bo Won Kim, Min Ji Shin, Bo Kwang Choi, Ji Hyun Kang, Yun Kyung Jeon, Sang Soo Kim, Bo Hyun Kim, In Ju Kim, Yong Ki Kim
1Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea. pons71@hanmail.net
2Kim Yong Ki Internal Medicine Clinic, Busan, Korea.
Acute suppurative thyroiditis is an uncommon infectious thyroid disease affecting mainly children and young adults. The route of infection is frequently a pyriform sinus fistula. The major pathogens responsible for acute bacterial suppurative thyroiditis are the Streptococcus and Staphylococcus species. In contrast, Actinomyces species are a very rare cause of acute suppurative thyroiditis. We experienced a case of a 23-year-old man who has presented general weakness and neck pain. Thyroid ultrasonography showed an ill-defined area of heterogeneous hypoechogenicity in the left lobe of the thyroid gland. Histologic examination by fine needle aspiration demonstrated gram-positive, filamentous-like organisms with branching hyphae and characteristic sulfur granules. Barium esophagogram showed a linear barium-filled track at the left pyriform sinus. We report a case of actinomycotic thyroiditis in a young adult with pyriform sinus fistula along with a brief review of related literature.
Key Words: Actinomycosis, Pyriform sinus fistula, Thyroiditis

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