Background: De Quervain’s thyroiditis due to its course is haracterized as a subacute, transient, self-limited thyroid inflammation with highly variable symptoms. The diagnosis is based on clinical examination and a fine needle biopsy.
Case Report: We report on a case of atypical de Quervain’s thyroiditis in a 34-year-old woman, that seemed to be undergoing a haemorrhage to the thyroid nodule with local flammatory symptoms such as lymph nodules enlargement and skin erythema, that mimicked suppurative thyroiditis. The patient was admitted to hospital because of a suddenly appearing painful thyroid nodule with rapidly intensifying pain in the jugular region and a fever up to 38,7 degrees centigrade.Relevant laboratory findings were:elevated erythrocyte sedimentation rate 40 mm/h and leucocytosis 16,2 x 109/dm 3. Thyroid ultrasound visualised an echoless space suggesting haematoma but fine needle biopsy did not revealed any blood in the bioptate. Considerable doubts in the differential diagnostics arose due to the enlargement of cervical lymph nodes and skin erythemapresent in suppurative thyroiditis. The eventual diagnosis of de Quervain’s thyroiditis was supported by: patient’s age, gender, fever up to 38,8 degrees centigrade, disorders of thyroid activity, a positive reaction to prednisone and a lack of reaction to antibiotics.
Conclusions: After a careful consideration of all clinical features, diagnosis of atypical de Quervain’s thyroiditis was established.

Keywords: de Quervain thyroiditis, haemorrhage to thyroid nodule, suppurative thyroiditis