Non-clostridial gas gangrene involving the thyroid gland complicated by multiple infections in a diabetic patient: a case report.

The thyroid gland is usually resistant to infection due to its nature, including rich blood supply and lymphatic drainage. Gas gangrene involving the thyroid is extremely rare and may be related to preexisting thyroid disease or diabetes. Few related cases have been reported, among which non-clostridial gas gangrene (NCGG) is particularly uncommon. Here, we briefly describe the diagnosis and treatment of a rare NCGG case involving the right lobe of the thyroid gland. A 60-year-old female patient presented with neck pain accompanied by discomfort during eating, which acutely worsened with sudden neck swelling one day before admission. Laboratory examination revealed fever, significantly elevated blood glucose, restricted neck movement, increased local skin temperature, and palpable crepitus in the cervical region. Based on clinical assessment, the patient was diagnosed with acute suppurative thyroiditis complicated by gas gangrene and poorly controlled diabetes. Intraoperative findings and post-operative histopathologic examination supported the diagnosis of NCGG. A right thyroid lobectomy was performed, along with resection of the isthmus and the left inferior thyroid pole, followed by vacuum sealing drainage with polyurethane. The patient recovered well, with no evidence of recurrence or complications at the 4-month follow-up. Successful management of this condition requires early debridement, resection of necrotic tissue, appropriate drainage, and close monitoring for potential airway complications, such as tracheomalacia.