Journal Article

First case report of thyroid abscess caused by Helicobacter cinaedi presenting with thyroid storm

Takehara, Tomohiro, Koh, Hidefumi, Watanabe, Mako, Tani, Tetsuo, Yajima, Ken, Otsuka, Yoshihito

2019

Overview

Background Helicobacter cinaedi is a microaerobic Gram-negative spiral-shaped bacterium that causes enteritis, cellulitis, and bacteremia in both immunocompromised and immunocompetent patients. While there have been increasing numbers of reported H. cinaedi infections recently, there has been no thyroid abscess case caused by H. cinaedi presenting with thyroid storm. Case presentation A 50-year-old Japanese man presented with a 9-day history of high fever associated with palpitations, dry cough, and chronic diarrhea. The patient had a history of Basedow’s disease that had been treated with thiamazole in the past. During the current episode, the patient was diagnosed with thyroid storm and treated accordingly. The blood culture taken on admission was positive for H. cinaedi . This finding was confirmed by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOFMS). A systemic computed tomography (CT) scan revealed a thyroid abscess as the site of infection and cause of the bacteremia. The 16S rRNA gene sequencing identified the pathogen of thyroid abscess as H. cinaedi . Clinical symptoms and laboratory data normalized on admission day 7 after treatment with both effective antibiotics and antithyroid drugs. Conclusions The case study described a patient with a history of Basedow’s disease that presented with a thyroid abscess caused by H. cinaedi with symptoms similar to those of thyroid storm. While this bacterium has been implicated in other infections, we believe this is the first time the bacteria has been documented to have caused a thyroid abscess.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Antibiotics / Bacteremia / Bacteria / Bacterial and fungal diseases / Bacterial infections / Basedow’s disease / Blood culture / Blood tests / Cardiac arrhythmia / Care and treatment / Case Report / Case reports / CAT scans / Cell culture / Cellulitis / Computed tomography / Cough / Diagnostic imaging / Diarrhea / Enteritis / Family medical history / Fever / Gastrointestinal diseases / Gene sequencing / Genes / Health aspects / Helicobacter cinaedi / Helicobacter pylori / HIV / HIV patients / Human immunodeficiency virus / Infection / Infections / Infectious Diseases / Internal Medicine / Ionization / Laboratories / Mass spectrometry / Mass spectroscopy / Medical Microbiology / Medical research / Medicine / Medicine & Public Health / Palpitations / Parasitology / Patients / Risk factors / RNA / rRNA 16S / Salmonella / Scientific imaging / Signs and symptoms / Spectroscopy / Thyroid / Thyroid abscess / Thyroid cancer / Thyroid storm / Tomography / Tropical Medicine