Primary Thyroid Tuberculosis: A Case Report from Jazan, Saudi Arabia

Thyroid tuberculosis is a rare disease. Diagnosis can be difficult because the clinical course is not very specificin most cases. Ziehl–Neelsen staining is frequently negative. Epithelioid granulomas and necrosis are the main biopsy findings.The diagnosis can be confirmed using polymerase chain reaction, detection of acid-fast bacilli, or bacteriological cultures.I report the case of a young patient who presented with anterior neck swelling. Primary thyroid tuberculosis was diagnosedbased on the clinical picture and fine-needle aspiration cytology findings. Treatment with a combination of anti-tuberculouschemotherapy was initiated using the WHO category I regimen, and the patient showed an excellent response to treatment. Tomy knowledge, this is only the second clinical case of primary thyroid tuberculosis to be reported in Saudi Arabia.In conclusion, tuberculosis of the thyroid gland should always be considered in the differential diagnosis of goiters, albeitbeing rare. The presence of cold abscesses and discharging sinuses in the midline of the neck raises suspicion of this disease,especially in endemic areas. The clinical presentation, in addition to strong evidence from fine-needle aspiration cytology, issufficient for the diagnosis of this condition.