title: Acute thyroid swelling and elevated C reactive protein.
abstract: A 34-year-old lady presented with a painful swelling of the left thyroid lobe since 1 week and elevated C reactive protein (CRP) above 100 mg/L. An ultrasound examination revealed a thyroid cyst with partly solid component, suitable with a haemorrhage into a cyst. The serum thyroid stimulating hormone (TSH), as well as peripheral thyroid hormones, was in the normal range. The acute swelling could be well explained by a haemorrhage, but not an elevated CRP. Her medical history was uneventful apart from a tooth extraction 2 weeks ago due to an infection. Therefore, our hypothesis was a haemorrhage into a pre-existing thyroid cyst during bacteraemia caused by the tooth infection. Conservative treatment with the aim of delayed hemithyreoidectomy failed due to a second episode of haemorrhage. During surgical resection pus drained out of the cyst and the histological report afterwards confirmed our tentative diagnosis. The patient was discharged 2 days later.
authors: Department of General Surgery, University Hospital Basel, Basel, Switzerland. christian.nebiker@usb.ch
authors: Christian A
authors: CA
authors: Nebiker
authors: Tarik
authors: T
authors: Delko
authors: Henryk
authors: H
authors: Zulewski
authors: Daniel
authors: D
authors: Oertli
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000175:diagnosis* / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D003560:Cysts / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D004487:Edema / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D061705:Image-Guided Biopsy; D013959:Thyroid Diseases / Q000175:diagnosis* / Q000378:metabolism
chemical_list: D002097:C-Reactive Protein
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