Clinical features of a case of brucellosis complicated with thyroid abscess
10.3760/cma.j.cn231583-20220810-00281
- VernacularTitle:布鲁氏菌病并发甲状腺脓肿1例患者的临床特征分析
- Author:
Tingfeng ZHOU
1
;
Guogang WANG
;
Xia LUO
;
Caiyue LI
;
Shuaiwei LIU
;
Ruiwen HAO
;
Peifang ZHANG
;
Xiangchun DING
Author Information
1. 宁夏回族自治区盐池县人民医院，吴忠 751100
- Keywords:
Brucellosis;
Thyroid abscess;
Clinical features
- From:
Chinese Journal of Endemiology
2024;43(2):133-136
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Clinical characteristics and diagnosis and treatment process was reported and analyzed of a patient with brucellosis complicated with thyroid abscess, providing reference for the clinical diagnosis of brucellosis complicated with thyroid abscess.Methods:Clinical medical records of a patient with brucellosis complicated with thyroid abscess who was treated at the General Surgery Department of Yanchi County People's Hospital in Wuzhong City, Ningxia Hui Autonomous Region in November 2021 were collected. The clinical manifestations, blood routine, brucella antibodies, thyroid function, bacterial culture, thyroid ultrasound and other examination results, as well as the diagnosis and treatment process, were comprehensively analyzed. Results:The patient was a male, 61 years old, who presented with a neck mass without typical clinical manifestations of brucellosis. Thyroid ultrasound revealed a space occupying lesion, and the preliminary diagnosis was thyroid cystadenoma. Thyroid right lobe and isthmus resection surgery was performed. During the operation, it was found that some of the thyroid glands were tightly adhered to the cervical blood vessels, so the resection surgery was changed to abscess drainage, and the drainage fluid was purulent and bloody. The bacterial culture result of thyroid purulent fluid (intraoperative puncture fluid and postoperative drainage fluid) was brucella lamblia, and the serum brucella test tube agglutination test titer was 1 ∶ 400 (+++). The patient improved and was discharged after local drainage and anti brucella treatment. Follow up for 4 months showed no abnormalities. Conclusions:Brucellosis which begins with a local infection of the thyroid gland is extremely rare, with no characteristic clinical manifestations, and is prone to misdiagnosis. Timely correction of the surgical plan during the treatment process avoids the removal of the patient's thyroid, which has a certain clinical reference value.
