An Abscess of Thyroid Remnant in a Positive Coronavirus Disease 2019 Patient

Abstract

Thyroid abscess is rare due to the unique anatomy and physiological features of the thyroid gland. The underlying thyroid disorder, thyroidectomy, immunocompromised conditions, and congenital third or fourth branchial arch anomalies are among the known risk factors. The association of COVID-19 with thyroiditis is recently reported and the inflammation of the thyroid gland may predispose to the abscess formation, especially in combination with other risk factors. The principle of management is by broad-spectrum antibiotics and evacuation of the abscess, with careful monitoring of thyroid hormone status. Serial aspiration is preferred in localized or less extensive cases to avoid possible complications like thyroid storm.  We present a unique case of thyroid abscess arising from the remnant of thyroid isthmus or pyramidal lobe in an immunocompetent patient with a history of total thyroidectomy and recently infected with COVID-19, successfully treated with serial aspiration and antibiotic.