Acute infectious thyroiditis (AIT) also known as suppurative thyroiditis, microbial inflammatory thyroiditis, pyrogenic thyroiditis and bacterial thyroiditis.The thyroid is normally very resistant to infection. Due to a relatively high amount of iodine in the tissue, as well as high vascularity and lymphatic drainage to the region, it is difficult for pathogens to infect the thyroid tissue. Despite all this, a persistent fistula from the piriform sinus may make the left lobe of the thyroid susceptible to infection and abscess formation. AIT is most often caused by a bacterial infection but can also be caused by a fungal or parasitic infection, most commonly in an immunocompromised host. Signs and symptoms
In most cases AIT is characterized by onset of pain, firmness, tenderness, redness or swelling in the anterior aspect of the neck. Patients will also present with a sudden fever, difficulty swallowing and difficulty controlling the voice. Symptoms may be present from 1 to 180 days, with most symptoms lasting an average of about 18 days. The main issue associated with the diagnosis of AIT is differentiating it from other more commonly seen forms of thyroid conditions. Pain, fever and swelling are often much more severe and continue to get worse in people who have AIT compared to those with other thyroid conditions. Causes
Despite the thyroid gland being extremely resistant to infection, it is still susceptible to infection by various bacteria. The cause can be almost any bacterium.
Bronchopneumonia is a subtype of pneumonia. It is the acute inflammation of the bronchi, accompanied by inflamed patches in the nearby lobules of the lungs.It is often contrasted with lobar pneumonia; but, in clinical practice, the types are difficult to apply, as the patterns usually overlap. Bronchopneumonia (lobular) often leads to lobar pneumonia as the infection progresses. The same organism may cause one type of pneumonia in one patient, and another in a different patient. Causes
Bronchopneumonia is usually a bacterial pneumonia rather than being caused by viral disease.It is more commonly a hospital-acquired pneumonia than a community-acquired pneumonia, in contrast to lobar pneumonia.Bronchopneumonia is less likely than lobar pneumonia to be associated with Streptococcus pneumoniae. Rather, the bronchopneumonia pattern has been associated mainly with the following: Staphylococcus aureus, Klebsiella, E. coli and Pseudomonas. Pathology
Bronchopneumonia may sometimes be diagnosed after death, during autopsy. On gross pathology there are typically multiple foci of consolidation present in the basal lobes of the human lung, often bilateral. These lesions are 2–4 cm in diameter, grey-yellow, dry, often centered on a bronchiole, poorly delimited, and with the tendency to confluence, especially in children. Light microscopy typically shows neutrophils in bronchi, bronchioles and adjacent alveolar spaces. Treatment
Compared to pneumonia in general, the association between the bronchopneumonia pattern and hospital-acquired pneumonia warrants greater consideration of multiple drug resistance in the choice of antibiotics. See also
Lobar pneumonia


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