ABSTRACT Acute Suppurative Thyroiditis (AST) is a very rare disorder of the thyroid gland, accounting for less than 1% of all thyroid diseases, owing to the protective mechanisms of the thyroid gland, including its rich vascular supply, extensive lymphatic drainage, well‐developed capsule, and high iodine content. Gram‐positive organisms are the most frequently reported etiological agents, while gram‐negative pathogens such as Escherichia coli are rarely reported, particularly in immunocompetent individuals. We describe the case of a 54‐year‐old male who presented with a painful anterior neck swelling and dysphagia. Laboratory findings revealed leukocytosis, elevated inflammatory markers, and normal thyroid function. Imaging revealed a multiloculated abscess involving the right thyroid lobe and isthmus. Fine‐needle aspiration yielded purulent material and culture‐confirmed Escherichia coli . The patient was successfully managed with intravenous antibiotics and ultrasound‐guided aspiration, with complete clinical resolution and no recurrence at follow‐up. This case highlights the need to consider atypical pathogens even in immunocompetent individuals.
Bhurtel et al. (Wed,) studied this question.