Tiroiditis aguda producida por Haemophilus influenza en un lactante menor

Objective: To report an uncommon case of an infant with acute thyroiditis caused by an inusual microorganism as Haemophilus influenzae. Methods: Data from clinical history, laboratory tests, ultrasonographic findings and management performed are summarized. The literature is reviewed. Results: A 17 months old male infant with fever, poor general conditions and a tender cystic mass in the neck region, without regional lymphadenopathies, was admitted. Leukocytosis with marked shift to the left (neutrophilous 88%, lymphocytes 7% and monocytes 3%) and elevated sedimentation rate (VSG: 48 mm) was found. Thyroid function studies were normal. Ultrasonography showed an abscess in the left thyroid lobe, and a acute suppurative thyroiditis was diagnosed. Surgical drainage and culture of the neck mass content was performed. Therapy with oxacilin was initiated, according to the most common organisms found in this pathology, but the evolution was not satisfactory. Haemophylus influenzae was identified in the culture and the antimicrobial was changed for ceftriaxone, showing better response. Underlying anatomic defects of the disease were excluded. Conclusion: Acute suppurative thyroiditis could occur in infants. It could be caused for unusual organisms. A broad spectrum antibiotic should be given before the organism is identified. The appropiate antimicrobial therapy is determined by the specific microorganism isolated. In order to prevent recurrence, anatomic congenital anomalies should be investigated and corrected, in all the cases.