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Case Reports in Endocrinology
Volume 2013, Article ID 741041, 4 pages
http://dx.doi.org/10.1155/2013/741041
Case Report

Aspergillus Thyroiditis: A Complication of Respiratory Tract Infection in an Immunocompromised Patient

1Department of Medicine, Division of Endocrinology and Diabetes, The University of Vermont College of Medicine, Burlington, VT 05401, USA
2Department of Medicine, The University of Vermont College of Medicine, Burlington, VT 05401, USA
3Department of Pathology and Laboratory Medicine, The University of Vermont College of Medicine, Burlington, VT 05401, USA

Received 10 October 2013; Accepted 19 November 2013

Academic Editors: T. Grüning, K. Iida, T. Kita, W. V. Moore, and R. Swaminathan

Copyright © 2013 Madiha M. Alvi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 59-year-old male with past medical history significant for non-Hodgkin’s lymphoma status after chemotherapy presented with acute onset of neck pain, odynophagia, and dysphagia associated with subjective fever, chills, and dyspnea. Physical findings included a temperature of 38.4°C, hypertension, and tachycardia. Patient was found to have anterior neck tenderness. Laboratory evaluation revealed neutropenia. The patient was started on empiric antibacterial and antiviral therapy and continued on home prophylactic antifungal treatment. Thyroid function tests revealed overt hyperthyroidism. A thyroid ultrasound showed heterogeneous echotexture without discrete nodules. Subacute thyroiditis was treated with methylprednisolone, metoprolol, and opiate analgesics. Patient’s antibacterial, antifungal, and antiviral treatments were broadened. A fine needle aspiration was not conducted. The patient’s condition deteriorated rapidly over his brief hospital course and he expired. Autopsy showed fungal thyroiditis secondary to disseminated invasive Aspergillus. This report describes the presentation of fungal thyroiditis secondary to disseminated invasive Aspergillus originating from the respiratory tract. The authors review the diagnostic challenges, pathophysiology, and treatment of this condition.