Acute thyroiditis

Description:

Thyroidites - diseases of a thyroid gland, various on an etiology and a pathogeny diffuzno of the increased thyroid gland call the Inflammation a strumitis.

The acute thyroiditis can be diffusion or focal, purulent and not purulent. The disease meets seldom.

Symptoms of the Acute thyroiditis:

At an early stage the thyroid gland is condensed, then abscess (abscess) of a thyroid gland is formed. Products of hormones in an inflammation zone are broken. However usually the zone of an inflammation does not take all gland or its most part, and hormonal disturbances in an organism do not happen. Usually the disease begins sharply, with sharp fervescence to 40 degrees. There is a strong fever, heart rate increases. There are severe pains in a thyroid gland which give to a mandible, a nape, ears, language.

Especially pains in a thyroid gland during the swallowing, cough amplify.
There are symptoms of the general intoxication of an organism:
- sharp weakness
- joint pain and muscles
- headaches.

Condition of the patient usually heavy. At palpation of a thyroid gland its local increase, sharply painful is found at a palpation. At the beginning of a disease this increase has a dense konstistention, at purulent fusion and formation of abscess, there is a softening. Skin on a neck over a thyroid gland reddens, becomes hotter.

Lymph nodes on a neck are usually increased and painful at palpation. Sometimes the purulent thyroiditis is complicated by break of pus from the center in a thyroid gland in the lying bodies (a trachea, a gullet, a mediastinum) nearby. Occasionally there can be a genenralization of infectious process to development of sepsis.

Complications of an acute thyroiditis.
The acute thyroiditis can come to the end with formation in tissue of a thyroid gland of an abscess which is capable to break, and it is good if outside. But if pus gets to surrounding fabrics, it can flow into pericardiac space; the progressing purulent inflammation in tissues of a neck is capable to lead to damage of vessels, a drift of a purulent infection to a meninx and tissues of a brain and even to development of the general blood poisoning by an infection (sepsis). It is necessary to treat an acute thyroiditis timely and very carefully.

Lack of treatment at a subacute thyroiditis can lead to the fact that rather large amount of tissue of thyroid gland will be damaged and as a result irreversible insufficiency of a thyroid gland will develop.

Duration of an acute purulent thyroiditis averages 1-2 months. Criterion of recovery is elimination of all infectious and inflammatory phenomena (normalization of indicators of the general blood test, body temperature, etc.). In the presence in a thyroid gland of abscess the last can be opened outside or in a mediastinum (mediastinitis), in a trachea (aspiration pneumonia, lung abscess). In some cases the hypothyroidism can be an outcome of an acute purulent thyroiditis.

The acute not purulent thyroiditis proceeds as an aseptic inflammation. The symptomatology is less expressed, than at an acute purulent inflammation of a thyroid gland.

Reasons of the Acute thyroiditis:

The acute purulent thyroiditis develops as a result of hematogenous distribution of acute or chronic infectious process (tonsillitis, pneumonia, sepsis, etc.)

The acute not purulent thyroiditis can develop after an injury, hemorrhage in a thyroid gland, radiation therapy.

Treatment of the Acute thyroiditis:

Treatment of an acute purulent tiroidit is carried out in surgical department of hospital. As soon as possible on establishment of the diagnosis antibacterial therapy is appointed. Surely investigate the microorganism which caused inflammatory process in a thyroid gland on sensitivity to antibiotics. At impossibility to define sensitivity to antibiotics, antibacterial drugs of a broad spectrum of activity (cephalosporins, antibiotics of a penicillinic row) are appointed.

Also drugs antihistaminic or antiserotoninovy are appointed:
- tavegil
- Suprastinum
- Peritolum
- Diazolinum.

To the patient plentiful drink, intravenous drop administration of Haemodesum, saline solutions, a reopoliglyukina for reduction of the general intoxication of an organism is appointed.

If in a thyroid gland abscess was already created, surgical treatment is carried out. The abscess cavity is opened, it is purulent the melted fabrics delete, in an abscess cavity leave a drainage. If not to open abscess in time, there can be its spontaneous opening in a trachea or a mediastinum that considerably will weight a condition of the patient.

If treatment is timely appointed, most of patients in 1,5-2 months recover. Very seldom after a purulent tiroidit there is depression of function of a thyroid gland – a hypothyroidism.