Surprise Struma: Suppurative Thyroiditis Found by In-111 WBC Imaging

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A 53-year-old woman with a long history of severe systemic lupus erythematosus immunosuppressed by therapeutic glucocorticosteroid therapy became febrile and severely ill. History and physical examination failed to indicate a source of infection. Cultures of body fluids were obtained and blood cultures grew Aspergillls nigricans; broad spectrum antibacterial and antifungal antibiosis was begun. An ln-111 WBC scan showed thyroid localization, and a CT scan showed a goiter with multiple thyroid abscesses. Needle aspiration culture material from the thyroid was sterile by microscopy and culture. The patient recovered uneventfully. The specific micro biologic etiology of her suppurative thyroiditis was never established.

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