Case Report: Conservative management of pediatric thyroid abscess with multispatial extension and transient thyrotoxicosis
Year: 2026
Type: article
Study design: Case Report
Abstract: Acute suppurative thyroiditis (AST) is a rare, potentially life-threatening bacterial infection of the thyroid gland, and surgical drainage has traditionally been regarded as standard care when an abscess forms. We report a case of a previously healthy 9-year-old boy who presented with fever, odynophagia, hoarseness, and neck stiffness and was found to have a left thyroid lobe abscess with multispatial cervical extension into the visceral, prethyroid, retropharyngeal, and parapharyngeal spaces, accompanied by transient biochemical thyrotoxicosis. Because the airway remained patent and systemic toxicity was absent, the patient was managed conservatively with intravenous antibiotics despite a non-yielding ultrasound-guided aspiration, resulting in rapid clinical improvement and normalization of inflammatory markers without operative drainage or recurrence at follow-up. Flexible laryngoscopy and a barium swallow showed no evidence of a pyriform sinus fistula, and thyroid function normalized without antithyroid therapy. This case highlights that carefully selected children with thyroid abscesses may recover without surgery despite radiological multispatial extension, and that the transient thyrotoxicosis of AST reflects destructive follicular injury, for which thionamides are generally not useful. Finally, it underscores the value of individualized, case-based management guided by airway status and clinical response rather than radiological extent alone.
Source: Frontiers in Pediatrics
Author: Abdullah K. Almutairi
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223032260