Journal Article•
Aspergillosis of the thyroid gland diagnosed by fine needle aspiration cytology.
About: This article is published in Acta Cytologica.The article was published on 2004-11-01 and is currently open access. It has received 7 citations till now. The article focuses on the topics: Aspergillosis & Thyroid.
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TL;DR: The spectrum of disease and presentation of AT may be shifting from what was primarily a postmortem finding to an antemortem diagnosis, necessitating a high index of clinical suspicion and timely intervention.
Abstract: Aspergillus involvement of the thyroid is the most commonly reported fungal thyroiditis. Aspergillus thyroiditis (AT) has primarily been a postmortem diagnosis in immunocompromised patients with diagnosed disseminated invasive Aspergillus or high suspicion of fungal infection during life. With better treatment modalities for the comorbidities that place patients at high risk for fungal infections, as well as better antifungal therapies for Aspergillus infections specifically, the spectrum of disease and presentation of AT may be shifting from what was primarily a postmortem finding to an antemortem diagnosis, necessitating a high index of clinical suspicion and timely intervention. We present a review of the literature to better clarify clinical features, diagnostic modalities, and management considerations pertaining to this disease.
15 citations
TL;DR: The patient's condition deteriorated rapidly over his brief hospital course and he expired, and autopsy showed fungal thyroiditis secondary to disseminated invasive Aspergillus originating from the respiratory tract.
Abstract: A 59-year-old male with past medical history significant for non-Hodgkin's lymphoma status after chemotherapy presented with acute onset of neck pain, odynophagia, and dysphagia associated with subjective fever, chills, and dyspnea. Physical findings included a temperature of 38.4°C, hypertension, and tachycardia. Patient was found to have anterior neck tenderness. Laboratory evaluation revealed neutropenia. The patient was started on empiric antibacterial and antiviral therapy and continued on home prophylactic antifungal treatment. Thyroid function tests revealed overt hyperthyroidism. A thyroid ultrasound showed heterogeneous echotexture without discrete nodules. Subacute thyroiditis was treated with methylprednisolone, metoprolol, and opiate analgesics. Patient's antibacterial, antifungal, and antiviral treatments were broadened. A fine needle aspiration was not conducted. The patient's condition deteriorated rapidly over his brief hospital course and he expired. Autopsy showed fungal thyroiditis secondary to disseminated invasive Aspergillus. This report describes the presentation of fungal thyroiditis secondary to disseminated invasive Aspergillus originating from the respiratory tract. The authors review the diagnostic challenges, pathophysiology, and treatment of this condition.
6 citations
Cites methods from "Aspergillosis of the thyroid gland ..."
...Fine needle aspiration (FNA) with subsequent cytology and culture remains the most frequent and most successful method used to diagnose AT [5, 6]....
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...Fine needle aspiration (FNA) with subsequent cytology and culture remains the recommended, most frequent and most successful method used to diagnose AT [5, 6]....
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TL;DR: The clinical challenge of diagnosing Aspergillus thyroiditis is summarized and the value of the early use of thyroid fine‐needle aspiration culture and the need for a high index of suspicion to reach the final diagnosis before disease dissemination are highlighted.
Abstract: Aspergillus thyroiditis (AT) has historically been considered a postmortem diagnosis in immunocompromised patients; most have disseminated disease. This report summarizes the clinical challenge of diagnosing AT. It also highlights the value of the early use of thyroid fine-needle aspiration culture and the need for a high index of suspicion to reach the final diagnosis before disease dissemination.
5 citations
TL;DR: A patient with cryoglobulinemic vasculitis who developed disseminated invasive aspergillosis with thyrotoxicosis caused by Aspergillus fumigatus is described.
Abstract: In immunocompromised patients, Aspergillus infections are important causes of morbidity and mortality We describe a patient with cryoglobulinemic vasculitis who developed disseminated invasive aspergillosis with thyrotoxicosis caused by Aspergillus fumigatus The diagnosis was based upon radiological, microbiological and pathological findings The patient was treated successfully with voriconazole and caspofungin treatment followed by total thyroidectomy We provide an overview of published reports on Aspergillus thyroiditis with an emphasis on therapeutic approaches
4 citations
TL;DR: This is the 10th case reported in the literature in an adult where the diagnosis of fungal invasion to the thyroid was able to be corroborated antemortem by fine needle aspiration biopsy.
Abstract: We describe a 20-year-old man diagnosed with a myelodysplastic syndrome (MDS), admitted to our hospital due to pancytopenia and fever of undetermined origin after myelosuppression with chemotherapy. Disseminated aspergillosis (DIA) was suspected when he developed skin and lung involvement. A rapidly growing mass was detected on the left neck area, during hospitalization. A thyroid ultrasound reported a cm oval heterogeneous structure, suggestive of an abscess versus a hematoma. Fine needle aspiration of the thyroid revealed invasion of aspergillosis. Fungal thyroiditis is a rare occurrence. Thyroid fungal infection is difficult to diagnose; for this reason it is rarely diagnosed antemortem. To our knowledge, this is the 10th case reported in the literature in an adult where the diagnosis of fungal invasion to the thyroid was able to be corroborated antemortem by fine needle aspiration biopsy.
2 citations