[Prolonged fever in painless subacute thyroiditis--diagnosis by gallium scan]

Patients with subacute, granulomatous thyroiditis usually present with a typical clinical picture of fever, anterior neck pain and an exquisitely tender thyroid. Abnormal thyroid function tests and suppressed radio-iodine uptake strongly support the diagnosis. Occasionally the disease may simulate systemic or malignant disease when it presents atypically, without signs or symptoms directly related to the thyroid, We report a 43-year-old man who presented with fever of unknown origin. A diagnosis of silent thyroiditis was made from evidence of biochemical thyrotoxicosis, intense gallium-67 citrate thyroidal localization, and an excellent response to aspirin.