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.
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A Case of Pyriform Sinus Fistula Concurrent with Papillary Thyroid Carcinoma in a 72-Year-Old Patient Yun Young Jung, Dongbin Ahn, Heejin Kim, Jin Ho Sohn Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2015; 58(1): 48. CrossRef
The incidence of adrenal incidentalomas has increased because imaging studies are now being more frequently performed, including abdominal sonography, CT and MRI. Although there is only a consensus on the treatment of adrenal incidentalomas from the National Institute of Health (NIH) conference 2003, it is generally accepted that surgical resection is required if there's any possibility of malignancy or functionality of the adrenal tumor. Abdominopelvic actinomycosis is a rare chronic progressive suppurative disease that is caused by gram-positive bacteria of the genus actinomyces, which is part of the normal flora of the oral cavity and gastrointestinal tract, with low virulence. Herein, we report on a case of adrenal actinomycosis that imitated a huge adrenal tumor in a 39-year-old women, and the adrenal actinomycosis was confirmed histologically only after adrenalectomy. To the best of our knowledge, this is the first Korean case report on actinomycosis that occurred in the adrenal gland.
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