Subacute Thyroiditis Without Neck Pain: An Unusual Cause of Persistent Fever in the Elderly Patient

TL;DR

Subacute thyroiditis can cause persistent fever in elderly patients even without neck pain, and it can be diagnosed and treated effectively with corticosteroids.

Contribution

Highlights subacute thyroiditis as an unusual but important cause of persistent fever in elderly patients, even when typical symptoms like neck pain are absent.

Findings

Subacute thyroiditis can present as fever of unknown origin in elderly patients.

Diagnosis relies on thyroid function tests and inflammatory markers, even in the absence of neck pain.

Corticosteroids provide rapid improvement in moderate-to-severe cases, with transient hypothyroidism often resolving spontaneously.

Abstract

Subacute thyroiditis can present as fever of unknown origin, particularly in elderly patients. Absence of neck pain or thyroid tenderness does not exclude the diagnosis. Thyroid function tests and inflammatory markers are key to diagnosis. Corticosteroids lead to rapid symptomatic improvement in moderate‐to‐severe cases. A transient hypothyroid phase is common and often resolves without long‐term thyroxine therapy.