A Case of Hemorrhage in the Thyroid Developed into Cervical Cellulitis

Abstract

We reported a case, of unknown cause, of hemorrhage in the thyroid that developed into cervical cellulitis. The patient is a 48-year-old female transferred to the emergency department in our hospital after three days of low-grade fever, slight difficulty in breathing and an enlarging painful nodule in the left cervical lesion. Initial diagnosis by her primary care doctor was subacute thyroiditis. Leukocyte and CRP counts were 10,000/Ul and 1.1 mg/dl, respectively, suggesting acute inflammation, but thyroid function was euthyroid. Thyroid echogram revealed a mass with a hypoechoic zone, so-called “echo free zone,” which contained a central partition. 0.5 ml of hemorrhagic fluid was evacuated by FNA. CT and MRI showed a poorly enhanced mass in the left lower thyroid lobe and extensive softy-tissue thickening in the previsceral and vascular visceral space. At this point, we considered the cause to be secondary cellulitis due to hemorrhage. The patient underwent a left hemithyroidectomy and drainage, and achieved a favorable course without lethal complications.