• Kevin D Pereira, Mallory J Highstein, Ariana G Greenwell, Amal Isaiah, and Tulio A Valdez.
• From the University of Maryland School of Medicine.
• Pediatr Emerg Care. 2021 Dec 1; 37 (12): e1416e1418e1416-e1418.

ObjectiveThe aim of this study was to determine if microbiological cultures can guide management of suppurative thyroiditis.DesignThis study is a retrospective case series set in 2 tertiary care academic hospitals.MethodsThe microbiological cultures from patients with suppurative thyroiditis who underwent incision and drainage from July 2004 to June 2018 were reviewed. Those who had confirmed pyriform sinus tracts and underwent surgical intervention were included in the study.ResultsFifteen patients satisfied the criteria for inclusion. All had confirmed pyriform sinus tracts and underwent successful intervention. Endoscopic cautery was the most common intervention followed by complete open excision. Five cultures grew alpha Streptococcus, 6 had Eikenella, and 4 Prevotella. Combinations of Eikenella + Prevotella were seen in 3, and 1 sample had all 3 bacteria. Two cultured methicillin-susceptible Staphylococcus aureus alone. One culture was sterile.ConclusionsThe presence of oral flora in an intrathyroidal abscess is confirmatory evidence of a pyriform sinus tract. Further investigations are not needed, and early definitive intervention can be planned.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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