Thyroid abscess: a rare condition in immunocompetent patient

Thyroid abscess is rare due to certain anatomical and physiological characteristics of the thyroid gland. Thyroid abscess can occur due to spread of flora in the upper respiratory tract to perithyroid space and thyroid gland through fistula. We are reporting case of thyroid abscess where the infecting pathogen was E. coli. USG and guided FNAC are simple and first line investigations. However there can be abscess formation following FNAC in immune compromised patients. A 50 years old man presented to us with complaints of fever and swelling over the left anterior aspect of neck of 10 days duration. It was associated with pain during swallowing. Ultrasound is investigation of choice as it does not have ionizing radiation, gives a good exposure of thyroid gland, show heterogeneous echo texture and superimposition of abscess is present. It can also show vascularity and internal haemorrhage. Patient was a case of undetected and uncontrolled diabetes mellitus which might have predisposed him to suppurative thyroiditis. Timely detection and surgical debridement of necrosed tissue and specific antibiotic treatment with management of diabetes helped him recover from this life threatening condition.