Thyroiditis is called inflammation of the thyroid gland, which has a different etiology. Acute thyroiditis is a rather rare pathology that can be diffuse, purulent, non-purulent, focal. The focal form of thyroiditis partially affects the organ. Diffuse spreads to the entire thyroid gland. The purulent form develops as a result of a chronic infection in the presence of sepsis, tonsillitis and other inflammatory diseases in the body. The non-purulent type of thyroiditis most often appears due to exposure to radiation therapy, hemorrhages in the thyroid gland.

Signs of the disease

The symptomatology of acute purulent and non-purulent thyroiditis differs, since ailments are caused by various reasons.

Symptoms of acute purulent thyroiditis

Provoke the emergence and development of the disease staphylococci, pneumococci, Escherichia coli. With a weakened immune system, infectious agents are thrown from the foci of chronic infection through the blood or lymph. With the early development of the disease, the thyroid gland begins to thicken, then an abscess forms on it, while the process of hormone production in the inflamed part of the gland is disrupted. The disease almost never captures most of the organ or its entirety, so there is no hormonal imbalance.

The disease manifests itself sharply, the following symptoms are observed:

• Muscle weakness.
• Increase in body temperature.
• Enlargement of lymph nodes (submandibular, subclavian, cervical).
• The formation of lymphadenitis (purulent inflammation, characterized by pain when probing the node, and reddening of the skin over it). This reaction indicates that the immune system is fighting the infection.
• Tachycardia.
• Chills.
• Pain in the throat that radiates to the back of the head, lower jaw. These pains are especially acute when swallowing, sneezing.
• On palpation of the thyroid gland, an increase in its individual parts is noted, sharply painful when pressed. If the disease has just begun, then the thyroid gland is dense to the touch, with the development of a purulent process, its softening is observed.

Symptoms of acute nonpurulent thyroiditis

The causes of the development of the disease are hemorrhages in the thyroid tissue, radiation or injury to this organ. At the same time, aseptic inflammation develops. In the acute form of non-purulent thyroiditis, the diagnosis is sometimes incorrectly made due to the similarity of symptoms with other diseases. Most often, the symptoms are attributed to chronic tonsillitis, SARS. With this type of disease, the symptoms are less pronounced.

The following symptoms are observed:

• subfebrile temperature (37-39 degrees);
• enlargement of the submandibular lymph nodes;
• pain on palpation of the lobes of the thyroid gland;
• in the throat area, you can find a soft area (formed abscess).

Diagnostics

To make a diagnosis and differentiate thyroiditis from other diseases, it is necessary to comprehensively examine the thyroid gland using laboratory and instrumental diagnostic techniques.

They include:

1. Venous blood analysis.
   In the acute form of thyroiditis, there are no deviations in TSH, T3, T4, antibodies to thyroglobulin and thyroid peroxidase in venous blood tests. If latent hypothyroidism has begun to develop, then the analysis will reveal an increase in TSH with normal T3 and T4 values. If TSH is elevated and at the same time the level of T3 and T4 is reduced, this indicates a developing overt hypothyroidism. In the blood, an increase in the erythrocyte sedimentation rate, neutrophilic leukocytosis is detected.
2. ultrasound.
   During an ultrasound examination, acute purulent thyroiditis is determined by a slightly enlarged thyroid gland with a heterogeneous echogenic structure. With a non-purulent type of acute thyroiditis, the size of the organ is not increased, spots with reduced echogenicity are observed . With Doppler sonography, an increase in the blood filling of the thyroid gland is determined.
3. Cytology.
   To take a sample, a fine needle biopsy is used, during which a needle is inserted into the thyroid gland. The aspirate is sucked off and sent for analysis. With the development of a purulent form of acute thyroiditis, cytology shows the presence of pus and necrotic tissues in the aspirate. Sowing on the microflora allows you to identify a bacterial pathogen and determine its sensitivity to antibacterial drugs. In acute non-purulent thyroiditis, cytology reveals an increase in the number of leukocytes in the sample, there are no neutrophils. No bacterial pathogen was found in the culture.

Therapy

Acute purulent thyroiditis is treated in the Department of Surgery. It is necessary to start antibiotic therapy as soon as possible. It is prescribed after a study of the sensitivity of the microorganism that caused the inflammatory process to antibiotics. If it is not possible to conduct such laboratory tests, then doctors prescribe broad-spectrum antibacterial drugs.

Prescribe antihistamines, droppers with hemodez, saline solutions to reduce the level of intoxication. If an abscess has developed, then surgical treatment is used, which consists in pumping out purulent contents or removing part of the thyroid gland.

Acute thyroiditis of the thyroid gland usually lasts from 4 weeks to 4 months, but with untimely treatment or late diagnosis of the disease, a large area of thyroid tissue is damaged, resulting in organ failure.

Treatment of non-purulent acute thyroiditis consists in taking analgesics and non-steroidal anti-inflammatory drugs. The disease lasts only a few days and ends most often safely.

Complications of the disease

Acute thyroiditis ends with the maturation of an abscess on the thyroid gland, which may break through sooner or later. Then the pus from the focus of inflammation enters the nearby organs, causing the development of various complications. If the purulent discharge breaks into the mediastinum, mediastinitis appears, if into the trachea, then pneumonia and lung abscess will develop. Sometimes the consequence of the acute form of the disease is hypothyroidism.

Thyroiditis is a dangerous disease. Chronic specific, subacute, acute, autoimmune thyroiditis – all these diseases entail negative consequences for the body. So if, with a purulent form of the disease, the infiltrate from the erupted abscess gets inside the tissues surrounding the thyroid gland, this will lead to damage to blood vessels, sepsis, and the transfer of infections to the membranes of the brain. Therefore, it is necessary to treat the acute form of thyroiditis immediately after the first symptoms appear. Then recovery will come quickly and there will be no dangerous consequences from the disease.