Thyroid abscess--an acute emergency.

An abscess in a long-standing goitre is usually life threatening. A patient with a large goitre was lost to follow-up for about 10 years and presented with a large thyroid abscess causing acute respiratory obstruction. The abscess caused erosion of the tracheal wall and perforation of the esophagus. Clostridium septicum was the causative organism, which is almost always associated with cancer of the colon. This led to the detection of colonic malignancy in this patient on further investigations. We describe the complications of a thyroid abscess and discuss the pathophysiology and treatment.