Tubercular thyroiditis: a case report

Tuberculosis of the thyroid gland is a rare disease even in countries in which tuberculosis (TB) constitutes an endemic disorder. The diagnosis is often difficult as the clinical presentation has no distinct characteristics. We report a case of 29-year-old woman who presented following an eventful course over two weeks with a bilateral diffuse swelling of the thyroid gland. Ultrasonography disclosed colloid nodules with abscess over left neck region. Thyroid function tests were initially normal followed by phases of hyper and hypothyroidism in the absence of significant symptoms. There was no evidence of tuberculosis in any other organ. FNAC of abscess and thyroid parenchyma revealed necrotizing epithelioid granulomas with positive ZN staining for AFB. The diagnosis of thyroid tuberculosis was therefore made. The patient was put on Category II ATT with stormy but favourable outcome. Although rarely encountered, tuberculosis should be kept in mind in the differential diagnosis of nodular lesions of the thyroid in our country.