Objective: To summarize our clinical experience with the diagnosis and treatment of children with acute suppurative thyroiditis (AST).
Methods: We retrospectively reviewed the clinical data of 18 children with AST treated at our hospital between January 2009 and May 2022.
Results: There were 8 boys and 10 girls, aged 7.8 ± 3.8 years at admission. The main clinical manifestations were fever (88.9%), neck pain (100%), and neck mass (100%). Blood and pus cultures were performed in 9 and 15 patients, respectively. All blood cultures were negative, while positive pus cultures were noted in eight cases (six Streptococcus spp., one Staphylococcus spp., and one Streptococcus spp. and Staphylococcus spp. mixed infection). Additionally, all patients received antibiotic treatment: three received antibiotics alone, seven received antibiotics and ultrasound (US)-guided needle aspiration, seven received antibiotics as well as surgical incision and drainage, and one received antibiotics, US-guided needle aspiration in addition to surgical incision and drainage. Consequently, the average length of hospital stay in patients who received antibiotics and US-guided needle aspiration was 9.1± 2.9 days compared to 14.0± 2.0 days in patients in the antibiotics alone group and 13.0 ± 2.2 days in patients in the antibiotics and surgical incision and drainage group. Follow-up was conducted in 15 of the 18 patients. Three patients relapsed, and the prognosis of the other patients was good.
Conclusion: AST has atypical clinical symptoms at the early stage. Regular monitoring of the thyroid gland using ultrasonography is strongly advised in unsure cases. Antibiotics combined with US-guided aspiration is a safe, effective, and minimally invasive treatment for AST in children and can reduce hospital stay. However, surgery may be necessary, particularly in the presence of complications. It is strongly recommended that patients with recurrence be examined for anatomical abnormalities and undergo radical treatment.

Keywords: children, acute suppurative thyroiditis, clinical manifestation, treatment


中文翻译：

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儿童急性化脓性甲状腺炎18例临床分析

目的：总结我们对小儿急性化脓性甲状腺炎（AST）的诊治经验。
方法：回顾性分析2009年1月至2022年5月在我院收治的18例AST患儿的临床资料。
结果：男8例，女10例，入院时年龄7.8±3.8岁。主要临床表现为发热（88.9%）、颈部疼痛（100%）、颈部肿块（100%）。分别对 9 名和 15 名患者进行了血液和脓液培养。所有血培养均为阴性，而 8 例脓液培养呈阳性（6 例链球菌属、1例葡萄球菌属和 1例链球菌属和葡萄球菌属 混合感染）。此外，所有患者均接受了抗生素治疗：3 例单独接受抗生素治疗，7 例接受抗生素和超声（US）引导针吸，7 例接受抗生素联合手术切开引流，1 例接受抗生素联合超声引导针吸手术切开引流。因此，接受抗生素和超声引导针吸的患者的平均住院时间为 9.1±2.9 天，而单独使用抗生素组的患者为 14.0±2.0 天，而接受抗生素和手术切口的患者的平均住院时间为 13.0±2.2 天和引流组。对 18 名患者中的 15 名进行了随访。3例患者复发，其余患者预后良好。
结论：AST早期临床症状不典型。在不确定的情况下，强烈建议使用超声检查定期监测甲状腺。抗生素联合超声引导吸引术是一种安全、有效、微创的儿童 AST 治疗方法，可减少住院时间。然而，手术可能是必要的，特别是在存在并发症的情况下。强烈建议对复发患者进行解剖异常检查并接受根治性治疗。

【关键词】：儿童 急性化脓性甲状腺炎 临床表现 治疗