Thyroid Tuberculosis

Thyroid TB is clinically rare. Lehrt first found it at autopsy in 1857. Of 2075 thyroid surgeries over 11 years at the Mayo Clinic, 21 (0.1%) were thyroid TB; domestic reports are 0.4-0.76%. It affects ages 20-50, children may also be affected, with female:male ~1:3-1:4.

Common Symptoms

Dietitian; goiter; anorexia; night sweats; fatigue; low fever; calcification; remittent fever; postpartum goiter; abscess

Causes and Pathogenesis

Thyroid TB is primary or secondary (mostly secondary). The thyroid has rich blood supply, dense lymphatics, and high oxygen tension, which generally do not favor TB growth; some argue the gland is highly immune and colloid antagonistic, so disease requires heavy virulent inoculum plus reduced immunity and local resistance. Recent studies show extrapulmonary TB rises markedly in HIV-positive patients (45-75%); Barner found 7% of disseminated TB involves the thyroid. Most cases accompany pulmonary TB (often asymptomatic); infection is mainly hematogenous (miliary TB), making thyroid TB a local manifestation of systemic disease; primary thyroid TB is extremely rare. Routes: direct spread from adjacent organ foci, then lymphatic spread. Pathological types: (1) Acute miliary (rare): part of systemic hematogenous dissemination, with uniform gray-white miliary tubercles throughout. (2) Caseous: tubercles caseate and necrose into cold abscesses with fibrous walls and adhesions, sometimes draining as sinuses. (3) Hyperplastic: nodular hard enlargement with scattered tuberculous granulomas and surrounding fibrosis.

Treatment

Drug therapy, supportive therapy, surgical treatment

Preventive Measures

Dietary requirements vary by symptoms; consult a doctor for individualized dietary standards.

Department to Visit

It is recommended to visit the Infectious Diseases department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.