SUPPURATIVE THYROIDITIS DUE TO NOCARDIA IN AN IMMUNOCOMPROMISED PATIENT

Objective: Nocardia is an opportunistic organism that usually infects immunocompromised patients. However, suppurative thyroiditis is a rare complication of nocardiosis. Methods: We report a case of Nocardia thyroiditis in an immunosuppressed patient following renal transplant. Results: A 45-year-old man presented with worsening diffuse muscle pain, weakness, and subjective fever. He had a significant history of recent renal transplant with immunosuppression at the time of presentation. Mild swelling was noted in the right submandibular area, and multiple papules were noted on the skin. Although pulmonary exam revealed no abnormalities, computed tomography revealed numerous bilateral small pulmonary nodules and multiple hypodense thyroid nodules. A positron emission tomography scan showed hypermetabolic activity in the mediastinum, lungs, thyroid, and skeletal muscles. During a right-thyroid lobectomy to rule out post-transplant lymphoproliferative disease, purulent discharge from a ruptured cyst was iden...