Thyroid abscess in case of Pre B acute lymphoblastic leukaemia: a rare presentation

• Published in: BMJ case reports Vol. 2016; p. bcr2016216523
• Main Authors: Kalantri, Siddhesh Arun, Datta, Saikat, Maitra, Dhritiman, Bhattacharyya, Maitreyee
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 29.11.2016; BMJ Publishing Group
• Series: Case Report
• Subjects: Abscess - pathology; Abscesses; Adolescent; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antineoplastic Combined Chemotherapy Protocols; Asia; Bone marrow; Clindamycin - therapeutic use; Cytogenetics; Drainage; Fever - etiology; Fever - pathology; Fever - therapy; Histopathology; Humans; Indian Sub-Continent; Induction therapy; Leukemia; Male; Medical imaging; Neutropenia; Neutrophils; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma - complications; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma - pathology; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma - surgery; Prednisolone - therapeutic use; Pyomyositis - complications; Pyomyositis - diagnosis; Pyomyositis - drug therapy; Rare Disease; Sepsis - diagnosis; Sepsis - drug therapy; Sepsis - etiology; Teicoplanin - therapeutic use; Thienamycins - therapeutic use; Thyroid Diseases - etiology; Thyroid Diseases - pathology; Thyroid Diseases - surgery; Thyroid gland; Thyroid Gland - pathology; Thyroidectomy; Treatment Outcome
• DOI: 10.1136/bcr-2016-216523
• ISSN: 1757-790X

Thyroid abscess is a very rare clinical condition. It usually occurs in immunocompromised individuals or those with underlying malignancy. We report a case of multiple thyroid abscesses in the patient with Pre B acute lymphoblastic leukaemia which developed secondary to hematogenous spread from pyomyositis of right calf muscle. The patient developed sepsis-associated disseminated intravascular coagulation, which got resolved after thyroidectomy. He became afebrile after surgical intervention. Unfortunately, all the cultures were negative. Since there are few case series and reports, there are no clear guidelines for management of thyroid abscess. We conclude that though rare, thyroid abscess may be the cause of persistent fever in immunocompromised patients.