Acute Suppurative Thyroiditis Extending to Retropharyngeal Space: Report of 2 Cases

Acute suppurative thyroiditis (AST) is a rare endocrine emergency, typically of bacterial origin, that can lead to significant morbidity and life-threatening complications. It is far less common than other inflammatory thyroid conditions, such as subacute thyroiditis, and may mimic noninfectious inflammatory disorders. Case 1 describes a 40-year-old man with a 5-day history of anterior neck swelling and odynophagia. Physical examination and imaging confirmed AST with retropharyngeal space involvement. He was treated with broad-spectrum intravenous antibiotics and thyroid abscess aspiration. Case 2 involved a patient with an 11-day history of fever and odynophagia. Imaging, including computed tomography and neck ultrasound, revealed a left thyroid lobe abscess extending into the retropharyngeal space. Further evaluation led to the diagnosis of a fourth branchial cleft cyst and a left pyriform fossa sinus tract. A multidisciplinary approach successfully managed both the acute infection and the underlying anatomical anomaly. Retropharyngeal extension of suppurative thyroiditis is exceedingly rare but signifies a severe disease progression with complex clinical implications. This report highlights the need to consider suppurative thyroiditis in the differential diagnosis of midline cervical infections.