Case 5-2024: A 36-Year-Old Man with Fevers

A 36 year old man presented with subacute fevers, throat swelling, and fatigue persisting for 18 days despite antibiotic therapy. Initial evaluations ruled out common infections (e.g., streptococcal pharyngitis, EBV, HIV). Imaging revealed no lymphadenopathy but noted thyroid abnormalities. Elevated inflammatory markers (CRP: 138.9 mg/L, ESR: 81 mm/hr) and hyperthyroidism (TSH <0.01 μIU/mL, elevated T3/T4) without antithyroid antibodies suggested postviral subacute thyroiditis, possibly triggered by an asymptomatic SARS-CoV-2 infection. The case highlights thyroiditis as a cause of prolonged fever and the importance of considering endocrine etiologies in febrile patients with nonspecific symptoms.

A 36 year old man presented with subacute fevers, throat swelling, and fatigue persisting for 18 days despite antibiotic therapy. Initial evaluations ruled out common infections (e.g., streptococcal pharyngitis, EBV, HIV). Imaging revealed no lymphadenopathy but noted thyroid abnormalities. Elevated inflammatory markers (CRP: 138.9 mg/L, ESR: 81 mm/hr) and hyperthyroidism (TSH <0.01 μIU/mL, elevated T3/T4) without antithyroid antibodies suggested postviral subacute thyroiditis, possibly triggered by an asymptomatic SARS-CoV-2 infection. The case highlights thyroiditis as a cause of prolonged fever and the importance of considering endocrine etiologies in febrile patients with nonspecific symptoms.