Diagnostic and Management Guidelines of Thyroid Tuberculosis: Our Experience and Systematic Review

Indian J Otolaryngol Head Neck Surg. 2023 Jun;75(2):1302-1310. doi: 10.1007/s12070-022-03275-y. Epub 2022 Nov 13.

Abstract

Objective: Thyroid tuberculosis has non-specific clinical presentation, difficult diagnosis and specific medical management. The aim of this article is to present and share a review of the English-language literature on thyroid tuberculosis in order to gain a better understanding of diagnostic methods and provide guidelines for its management and to present our experience of three cases.

Methods: The systematic search of the literature was performed on Pubmed and Medline from 1950 to 2019 according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement.

Results: We retrieved 13 manuscripts meeting our criteria from the search. There were 7 case series, and 6 manuscripts with review of the literature.

Conclusion: Direct histopathological demonstration is the best diagnostic modality. FNAC is the study of choice and PCR assay increases its sensitivity. The standard short course ATT for 6 months is recommended for isolated thyroid TB and for widespread disease, 12 months therapy is recommended. Surgery is reserved for failure of medical therapy and abscess formation.

Keywords: Bacterial culture; Fine needle aspiration cytology; Medical management; Polymerase chain reaction; Thyroid tuberculosis.