CLINICAL COMMUNICATION TO THE EDITOR
A Pain in the Neck: Thyroid Abscess To the Editor: A 43-year-old man presented with a 2-day history of fever and left neck swelling. Two years previously he was the recipient of a deceased-donor kidney transplant. He had experienced chronic renal allograft rejection and had chronic hepatitis C infection. His current medications included mycophenolate mofetil, prednisone, and tacrolimus. Upon examination, his left anterolateral neck was swollen, warm, and tender. Hematologic testing revealed a white blood cell count of 21.8 K/mm3 with a neutrophil count of 19.4 K/mm3. A computed tomography scan of the neck showed a 3-cm 3-cm 9-cm complex fluid collection in the left thyroid lobe that extended superiorly to the submandibular region, inferiorly to the clavicular head, and medially to the isthmus (Figure, A and B, arrows). The left carotid sheath was displaced laterally and a mild mass
Funding: None. Conflict of Interest: None. Authorship: All authors had access to the data and a role in writing the manuscript. Requests for reprints should be addressed to Jennifer Brown, MD, Division of Infectious Diseases, Department of Internal Medicine, University of California, Davis Medical Center, 4150 V. Street, PSSB G500, Sacramento, CA 95817. E-mail address: [email protected]
effect was evident on the trachea. Blood cultures and specimens of the thyroid fluid collection grew methicillinsusceptible Staphylococcus aureus. Thyroid abscesses are rare, comprising
A Pain in the Neck: Thyroid Abscess To the Editor: A 43-year-old man presented with a 2-day history of fever and left neck swelling. Two years previously he was the recipient of a deceased-donor kidney transplant. He had experienced chronic renal allograft rejection and had chronic hepatitis C infection. His current medications included mycophenolate mofetil, prednisone, and tacrolimus. Upon examination, his left anterolateral neck was swollen, warm, and tender. Hematologic testing revealed a white blood cell count of 21.8 K/mm3 with a neutrophil count of 19.4 K/mm3. A computed tomography scan of the neck showed a 3-cm 3-cm 9-cm complex fluid collection in the left thyroid lobe that extended superiorly to the submandibular region, inferiorly to the clavicular head, and medially to the isthmus (Figure, A and B, arrows). The left carotid sheath was displaced laterally and a mild mass
Funding: None. Conflict of Interest: None. Authorship: All authors had access to the data and a role in writing the manuscript. Requests for reprints should be addressed to Jennifer Brown, MD, Division of Infectious Diseases, Department of Internal Medicine, University of California, Davis Medical Center, 4150 V. Street, PSSB G500, Sacramento, CA 95817. E-mail address: [email protected]
effect was evident on the trachea. Blood cultures and specimens of the thyroid fluid collection grew methicillinsusceptible Staphylococcus aureus. Thyroid abscesses are rare, comprising
