{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:06:18Z","timestamp":1792037178995,"version":"4.4.0"},"reference-count":14,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:p>A previously healthy 17-year-old female patient initially presented with symptoms of anterior neck pain. After multiple emergency department visits, she was found to have unilateral enlargement of her thyroid gland. Laboratory studies were consistent with hyperthyroidism. Symptoms were initially attributed to subacute thyroiditis, and she was discharged with steroids and propranolol. She presented again 1 week later with complaints of nausea, vomiting, abdominal pain, and shortness of breath. She was readmitted and developed sepsis with multiorgan system infection and Lemierre syndrome. Further imaging revealed acute suppurative thyroiditis as the likely source. Direct laryngoscopy and bronchoscopy revealed ulceration of the anterior esophageal wall, a fistulous tract to the thyroid, and copious purulent drainage. Esophageal biopsies with immunostaining established a diagnosis of herpes simplex virus esophagitis as the likely cause of esophageal perforation, fistula development, and acute suppurative thyroiditis.<\/jats:p>","DOI":"10.1542\/peds.2024-066068","type":"journal-article","created":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T08:06:43Z","timestamp":1730794003000},"source":"Crossref","is-referenced-by-count":2,"title":["A Rare Presentation of Acute Suppurative Thyroiditis"],"prefix":"10.1542","volume":"154","author":[{"given":"Alexandra D.","family":"Blumer","sequence":"first","affiliation":[{"name":"aDepartment of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Bloom","sequence":"additional","affiliation":[{"name":"bDepartment of Radiology, University of Michigan Medical School, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodi S.","family":"Ehrmann","sequence":"additional","affiliation":[{"name":"aDepartment of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2024,11,5]]},"reference":[{"key":"2024121614375088300_B1","volume-title":"Endotext","author":"Majety","year":"2000"},{"key":"2024121614375088300_B2","volume-title":"Suppurative Thyroiditis in Children and Adolescents","author":"Brook"},{"key":"2024121614375088300_B3","volume-title":"Overview of Thyroiditis","author":"Burman"},{"issue":"10","key":"2024121614375088300_B4","doi-asserted-by":"crossref","first-page":"e384","DOI":"10.1097\/INF.0000000000004024","article-title":"Acute suppurative thyroiditis in children: clinical decision-making","volume":"42","author":"G\u00f3mez","year":"2023","journal-title":"Pediatr Infect Dis J"},{"issue":"2","key":"2024121614375088300_B5","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1111\/cen.14440","article-title":"Suppurative thyroiditis: systematic review and clinical guidance","volume":"95","author":"Lafontaine","year":"2021","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"8","key":"2024121614375088300_B6","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1001\/jama.2024.0179","article-title":"International consensus criteria for pediatric sepsis and septic shock","volume":"331","author":"Schlapbach","year":"2024","journal-title":"JAMA"},{"key":"2024121614375088300_B7","unstructured":"Pomerantz\u2008WJ, Weiss\u2008SL. Sepsis in children: definitions, epidemiology, clinical manifestations, and diagnosis. Available at: https:\/\/www.uptodate.com\/contents\/sepsis-and-septic-shock-in-children-in-resource-abundant-settings-ongoing-management-after-resuscitation?topicRef=6395&source=see_link. Accessed October 1, 2024"},{"key":"2024121614375088300_B8","article-title":"Lemierre syndrome: septic thrombophlebitis of the internal jugular vein","author":"Spelman"},{"issue":"7","key":"2024121614375088300_B9","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1007\/s10096-004-1161-1","article-title":"Case of Lemierre\u2019s syndrome presenting with thyroid abscess","volume":"23","author":"Kara","year":"2004","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2024121614375088300_B10","first-page":"101651","article-title":"Case report of atypical Lemierre\u2019s Syndrome associated with Fusobacterium nucleatum infection without internal or external jugular venous thrombophlebitis","volume":"37","author":"Nguyen","year":"2022","journal-title":"Respir Med Case Rep"},{"key":"2024121614375088300_B11","volume-title":"Herpes Simplex Virus Infection of the Esophagus","author":"Bonis"},{"issue":"4","key":"2024121614375088300_B12","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1097\/MD.0b013e3181e949ed","article-title":"Herpes esophagitis in healthy adults and adolescents: report of 3 cases and review of the literature","volume":"89","author":"Canalejo","year":"2010","journal-title":"Medicine (Baltimore)"},{"issue":"1","key":"2024121614375088300_B13","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.1097\/MJT.0b013e318220500f","article-title":"A difficult case to swallow: herpes esophagitis after epidural steroid injection","volume":"21","author":"Davis","year":"2014","journal-title":"Am J Ther"},{"issue":"1","key":"2024121614375088300_B14","first-page":"e33640","article-title":"A case of left ventricular thrombus and herpetic esophagitis in an immunocompetent patient with covid-19","volume":"15","author":"Mohamed","year":"2023","journal-title":"Cureus"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2024-066068\/1750446\/peds.2024-066068.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2024-066068\/1750446\/peds.2024-066068.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T14:39:01Z","timestamp":1734359941000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/154\/6\/e2024066068\/199825\/A-Rare-Presentation-of-Acute-Suppurative"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,5]]},"references-count":14,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,11,5]]},"published-print":{"date-parts":[[2024,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2024-066068","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,5]]},"article-number":"e2024066068"}}