Neck swelling and fever

A woman in her 30s was admitted to the emergency department with a painful left sided neck swelling that had developed over four days and was red and hot to touch. She had fever, tachycardia, and tachypnoea on observation. She had been taking oral steroids and oral antibiotics for presumed subacute thyroiditis for the past three weeks and had no known immunosuppressive disease. Computed tomography imaging of the neck excluded deep neck space infection and showed a thyroid abscess on the left lobe (fig 1). The abscess was surgically drained and the patient had a left thyroid lobectomy with no complications. Thyroid abscesses are a rare cause of painful neck swelling and may initially be thought to be subacute thyroiditis.1bmj;383/oct05_8/e074754/F1F1f1Fig 1
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