Fever of unknown origin: Subacute thyroiditis versus typhoid fever

Fever of unknown origin as the major manifestation of subacute thyroiditis

Fever of unknown origin is a commonly encountered medical problem. Most common causes include infections, malignancy, and connective tissue diseases. Endocrine causes are rare but are well documented. While fever is common in some endocrine disorders, fever of unknown origin as the sole presenting feature is very rare. We describe a case report of a 63-year-old male who presents with fever of unknown origin. Imaging and biopsy results confirmed the diagnosis of subacute thyroiditis. He was started on prednisone with a good response. We conclude that subacute thyroiditis should be considered in the work up of fever of unknown origin even in the absence of classical signs and symptoms.

Fever of unknown origin: a clinical approach

Fevers of unknown origin remain one of the most difficult diagnostic challenges in medicine. Because fever of unknown origin may be caused by over 200 malignant/neoplastic, infectious, rheumatic/inflammatory, and miscellaneous disorders, clinicians often order non-clue-based imaging and specific testing early in the fever of unknown origin work-up, which may be inefficient/misleading. Unlike most other fever-of-unknown-origin reviews, this article presents a clinical approach. Characteristic history and physical examination findings together with key nonspecific test abnormalities are the basis for a focused clue-directed fever of unknown origin work-up.

Subacute thyroiditis (de Quervain's) due to influenza A: presenting as fever of unknown origin (FUO)

Subacute (de Quervain's) thyroiditis is a rare but important cause of fever of unknown origin. Most cases of subacute thyroiditis are caused by a variety of viruses, for example, Coxsackie, cytomegalovirus, Epstein-Barr virus, and adenovirus. Influenza immunization or infection may cause subacute thyroiditis. We present the first reported case of a fever of unknown origin due to seasonal influenza A in a 67-year-old woman.

Subacute thyroiditis presenting as fever of unknown origin

Subacute thyroiditis is a painful, inflammatory disease of the thyroid gland, probably of viral origin. It is an uncommon but important cause of fever of unknown origin (FUO). We report a case of a 72-year-old man who presented with a 1 month history of fever, headache and weakness, and in whom extensive evaluation only revealed subacute thyroiditis. He was treated with low-dose steroids and became asymptomatic after 2 weeks. In conclusion, when a patient presents with FUO, subacute thyroiditis should be considered as a possible cause even if classic features are absent.

Subacute thyroiditis following influenza vaccine (Vaxigrip) in a young female

Subacute thyroiditis (SAT), also called de Quervain thyroiditis or granulomatous thyroiditis, is a self-limiting, possibly viral, and inflammatory thyroid disorder that is usually associated with thyroid pain and systemic symptoms. This report details a case of SAT possibly associated with influenza vaccine (Vaxigrip) in a young female. The diagnosis, therapeutic management and outcome are discussed.