Acute thyroiditis may involve a normal gland, or arise in a multinodular goiter. At times, no source of infection can be demonstrated. The possibility of a persistent thyroglossal duct should be considered for patients with midline infections. Pathology Pathological examination reveals characteristic changes of acute inflammation. With bacterial infections, heavy polymorphonuclear and lymphocytic cellular infiltrate is found in the initial phase, often with necrosis and abscess formation.
Fibrosis is prominent as healing occurs.
In material obtained by fine needle aspiration, the infectious agent may be seen on a gram, acid fast or appropriate fungal stains. Fungal thyroiditis was clearly demonstrated in a patient with candida albicans 4 . Clinical Manifestations Acute thyroiditis is quite rare with no more than one to two patients per year observed in a large tertiary care hospital. As the number of immunocompromised patients increase, cases of suppurative thyroiditis are increasing. It may be somewhat more common in the pediatric age group, although it is still quite unusual.