Journal of Thyroid Disorders & Therapy
Open Access

Thyroid Tuberculosis: Diagnosis, Treatment, and Prognosis of a Rare Symptom

Emmouh Soufyane^{* *}Correspondence: Emmouh Soufyane, Department of Medicine, Paris-Saclay University, Paris, France, Email:

Author info »

Description

Thyroid tuberculosis, although a rare manifestation of Tuberculosis (TB), occurs when the bacterium Mycobacterium tuberculosis infects the thyroid gland. Tuberculosis is primarily known for affecting the lungs, but it can affect various parts of the body, including the thyroid gland, through the bloodstream or lymphatic system. Thyroid tuberculosis, also known as tuberculous thyroiditis, presents as a granulomatous inflammation within the thyroid tissue due to the infiltration of tuberculosis bacteria.

The exact incidence of thyroid tuberculosis is not welldocumented due to its rarity. However, it is considered an uncommon form of extrapulmonary tuberculosis. Risk factors for developing thyroid tuberculosis include a history of tuberculosis infection elsewhere in the body, immunocompromised states (such as HIV/AIDS or immunosuppressive medications), and living in regions with a high prevalence of tuberculosis.

Symptoms of thyroid tuberculosis are often nonspecific and may mimic other thyroid disorders. Patients may experience neck pain, swelling, or a palpable mass in the neck region. There might be signs of thyroid dysfunction, such as hypothyroidism or hyperthyroidism, depending on the extent of thyroid involvement and the damage caused by the infection. Some individuals may also present with systemic symptoms like fever, weight loss, fatigue, and night sweats, which are common manifestations of tuberculosis infection.

Diagnosing thyroid tuberculosis can be challenging due to its rarity and nonspecific symptoms. Physicians typically consider a combination of clinical history, physical examination findings, imaging studies, and laboratory tests for an accurate diagnosis. Imaging modalities like ultrasound, Computed Tomography (CT) scans, or Magnetic Resonance Imaging (MRI) can reveal abnormalities in the thyroid gland, such as nodules, abscesses, or enlarged lymph nodes in the neck. Fine-Needle Aspiration Biopsy (FNAB) may be performed to obtain a tissue sample for microscopic examination and to confirm the presence of tuberculosis bacteria.

Treatment of thyroid tuberculosis involves a multidrug regimen consisting of anti-tuberculosis medications, similar to the standard treatment for pulmonary tuberculosis. The most common drugs used in the treatment of tuberculosis are isoniazid, rifampicin, ethambutol, and pyrazinamide. Patients typically undergo a prolonged course of treatment, usually lasting six to nine months or longer, under the supervision of healthcare professionals. Compliance with the full course of medication is crucial to prevent the development of drug resistance and ensure successful treatment outcomes.

In some cases, surgical intervention may be necessary, especially if there are complications such as the formation of abscesses or significant compression of nearby structures due to the enlarged thyroid gland. Surgery might involve draining the abscess or excising part of the thyroid gland (partial thyroidectomy) to manage complications and aid in the resolution of the infection. However, surgery is usually considered after initiating antituberculosis medication and when there is an inadequate response to medical treatment alone.

Prognosis for thyroid tuberculosis is generally good with appropriate and timely treatment. Early diagnosis and initiation of anti-tuberculosis medication help in preventing complications and reducing the risk of long-term sequelae. Most patients show improvement in symptoms and reduction in the size of thyroid nodules or abscesses with proper treatment. However, delayed diagnosis or inadequate treatment can lead to persistent infection, abscess formation, or potential damage to the thyroid gland, resulting in hypothyroidism or other complications.

Prevention of thyroid tuberculosis primarily revolves around preventing tuberculosis infection in general. This includes maintaining good hygiene practices, adhering to tuberculosis vaccination programs where available, and identifying and treating tuberculosis cases promptly to prevent its spread within communities.

Conclusion

In conclusion, thyroid tuberculosis is a rare manifestation of tuberculosis that affects the thyroid gland. It presents challenges in diagnosis due to its rarity and nonspecific symptoms. Timely identification through a combination of clinical evaluation, imaging studies, and laboratory tests, followed by a multidrug regimen of anti-tuberculosis medications, forms the cornerstone of treatment. With proper management, including medication adherence and, in some cases, surgical intervention, most individuals can achieve favorable outcomes and resolution of thyroid tuberculosis. Early detection and comprehensive treatment are crucial for preventing complications and promoting recovery in cases of thyroid tuberculosis.