What is Thyroiditis? Inflamed Thyroid Gland, Types of Thyroiditis

Thyroiditis is the term for inflammation of the thyroid gland, the bilobular gland located just below the voice box (larynx). The thyroid gland has several functions in the body but is best known for regulating the metabolism through the action of the thyroid hormones, thyroxine (T4) and triiodothyronine (T3). Thyroiditis includes several diseases of the thyroid gland with varying presentation and etiology – from infections to autoimmune disorders and drugs.

Although inflammation is almost always associated with pain, there are forms of thyroiditis where pain is absent and other features of inflammation are minimal. Some of these disorders are characterized primarily by the effect of abnormal levels of thyroid hormones. Thyroiditis may be acute, subacute or chronic – most acute and subacute types of thyroiditis are due to infections, while chronic thyroiditis is usually due to autoimmune factors.

Thyroiditis may lead to either an excess or deficiency of thyroid hormones. Some types of thyroiditis can be treated thereby restoring normal thyroid functioning. However in those types of thyroiditis where treatment cannot restore normal thyroid activity,  synthetic thyroid hormones or antithyroid medication is used to counteract the effects of thyroid dysfunction.

Acute thyroiditis is due to infections and often referred to as infectious thyroiditis. It can be caused by any pathogen but most cases are due to bacterial infections. Acute infectious thyroiditis usually does not result in thyroid dysfunction although mild hypothyroidism may be present at times. However this will resolve once the infection settles or is treated appropriately.Subacute granulomatous thyroiditis, also known as de Quervain’s thyroiditis, may possibly be triggered by a viral infection. Subacute lymphocytic thyroiditis (painless thyroiditis)  is linked to autoimmune causes and is similar to post partum thyroiditis. All these types of thyroiditis are characterized by hyperthyroidism (thyrotoxicosis) followed by hypothyroidism and usually lasts for 12 to 18 months.Hashimoto’s thyroiditis is a chronic type of thyroiditis that is due to autoimmune factors. The pathogenesis is closely related to subacute lymphocytic (painless) thyroiditis and post partum thyroiditis. It is characterized by hypothyroidism with thyrotoxicosis rarely seen in the initial stages of the disease.Drug-induced thyroiditis and radiation thyroiditis arise as a result of  therapeutic measures like the use of lithium or chemotherapeutic agents, radioactive iodine or radiation therapy. With drug-induced thyroiditis, the thyroid dysfunction (either thyrotoxicosis or hypothyroidism) usually wears off after stopping the drug. In radiation thyroiditis, however, the hypothyroidism that may follow the initial hyperthyroidism is usually permanent.Reidel’s thyroiditis or fibrous thyroiditis is rare type of chronic thyroiditis that results in the growth of fibrous tissue in the thyroid gland. The cause of Reidel’s thyroiditis is unknown but is possibly due to autoimmune factors.

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Prostate Gland Infection (Acute, Chronic) Causes and Symptoms

Infection of the prostate gland is mainly due to bacteria and is therefore known as bacterial prostatitis. It can be acute or chronic and is  often associated with other prostate or urinary tract pathology. The microorganisms are usually present in the urine but can reach the prostate through the blood stream, lymphatic system or directly from neighboring structures like the rectum.

The risk of developing prostatitis increases substantially if there is a history of urinary tract infections, bladder outlet obstruction, benign prostatic hyperplasia, sexually transmitted diseases (STDs), unprotected anal intercourse, transurethral surgery, catheterization or phimosis.

Bacterial prostatitis is less common than other non-infectious causes. In acute prostatitis, usually the same bacteria that are involved in urinary tract infections may also infect the prostate. This includes E.coli, enterococci and staphylococci. With chronic prostatitis, however, the are a host of microorganisms that may also play a role in infection, including Klebsiella spp, Enterobacter spp, staphylococci, Pseudomonas spp and enterococci.

The microorganisms gain entry into the prostatic tissue through multiple routes. The most common is when microorganisms enter through the penile urethra and spread up the urinary tract. This is known as an ascending urethral infection. Microorganisms in the urine may also enter the prostatitic ducts, against the regular flow of urine. This is known as reflux of infected urine. In acute prostatitis, these routes of transmission are usually responsible.

Bacterial prostatitis may also arise through direct infiltration of the rectal bacteria. Lymphatic spread of the rectal bacteria and hematogenous spread of bacteria through the blood stream from distant sites may also be responsible.

The symptoms of acute bacterial prostatitis are usually intense while in chronic cases, the presentation may be mild or even asymptomatic.

Frequent urinationPainful urination (dysuria)Difficulty passing urinePerineal pain or groin pain – may also involve the penis and scrotumLow back acheTenderness, warmth and swelling of the prostate gland may be more evident in acute bacterial prostatitisFever and chills are more frequently seen in acute bacterial prostatitisMalaise, arthralgia (joint pain) and myalgia (muscle pain) are usually indicate of an acute infectionSexual dysfunction is more likely to arise with chronic bacterial prostatitis and patients may also report pain during ejaculation.

The risk of developing a prostatitic abscess exists especially with acute bacterial prostatitis and may require drainage.

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