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Case Report

Pyrexia of unknown origin: it can be de Quervain’s thyroiditis!

Sangita Deepak Kamath, Sweta Miniz, Sujata Mitra, Ballamudi Srinivas Rao.


Singer classified inflammatory diseases of the thyroid into three broad categories: acute, subacute, and chronic thyroiditis. Subacute disease includes granulomatous or de Quervain’s thyroiditis and lymphocytic thyroiditis (silent); whereas the chronic group includes chronic lymphocytic (Hashimoto’s thyroiditis) and fibrous (Riedel’s) thyroiditis. Subacute thyroiditis (de Quervain’s thyroiditis) is an uncommon, painful thyroid inflammatory disorder. This condition can manifest in various clinical forms. Physicians must be aware of its clinical features to make the correct diagnosis and initiate treatment appropriately. We report two cases that went from pillar to post without proper diagnosis for 4 weeks undergoing a battery of unnecessary investigations, causing emotional trauma, and increasing cost of the treatment. Although it is a self-limiting disease without mortality, it can be incapacitating due to its smoldering symptoms. A high index of suspicion is hence required for timely diagnosis and initiating appropriate therapy.

Key words: Thyroiditis, odynophagia, neck pain, technetium-99 pertechnetate

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