Disseminated zygomycosis presenting as thyroid abscess in a renal allograft recipient.

In the current medical environment, thyroid abscess is a clinical entity that is seldom encountered; however, it was a common condition in the era before antibiotics [1,2]. Review of the published causes of thyroid abscess since 1980 demonstrated that although Gram-positive bacteria (Staphylococcus and Streptococcus species) remain the most common causes, there have been a number of cases in the literature, caused by mycobacteria, Salmonella species and anaerobes [2]. Fungal thyroid infections are very rare and described in immunosuppressed patients. Immunocompromised patients, such as those with leukaemia, lymphoma, autoimmune diseases and organ-transplant patients on pharmacological immunosuppression, are particularly at risk. Aspergillus is by far the most common cause of fungal thyroiditis [3]. However, zygomycotic thyroiditis is rarely reported in the literature. To the best of our knowledge, there are only four reports in the literature, of disseminated zygomycosis in which thyroid was also involved [4–7]. Possibly, ours is a fifth case in which a live unrelated renal allograft recipient (LURRAT) presented with thyroid abscess antemortem, which was diagnosed at autopsy with disseminated zygomycosis.