A Fistula From Pyriform Sinus in Recurrent Acute Suppurative Thyroiditis

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Abstract
Acute suppurative thyroiditis is rare in children, and the route of infection is unknown in most cases.1-3 Recently, we have encountered three patients with recurrent episodes of this disease. In this report we describe a fistula originating at the pyriform sinus that was one of the routes of infection in acute suppurative thyroiditis. Report of Cases.—The patients were three girls aged 3, 6, and 15 years. Each had had two episodes of acute suppurative thyroiditis in the left lobe of the thyroid gland. The second episode of this disease occurred eight months after the first in the 3-year-old, 48 months in the 6-year-old, and five months in the 15-year-old. The diagnosis of acute suppurative thyroiditis was based on the clinical signs of inflammation in the region of the thyroid gland and on laboratory findings. In all patients, circulating concentrations of thyrotropin, thyroxine, and triiodothyronine remained Internal fistula (arrows)

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