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Diagnosed with acute thyroiditis. Enlarged and swollen thyroid. Difficulty in swallowing and pain in back. Is it thyroid infection?

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Practicing since : 1998
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I was diagnosed with acute thyroiditis in India where i am presently living. Symptoms are : enlarged, swollen, painful thyroid, especially right side with difficulty swallowing and pain in the back of the neck and occipital area. Exhaustion, sleeplessness. I was given first naproxen 250x2 a day but it did not help, got worse and now have been prescribed omnacortil (prednisolone 10 mg) and inderal 10. I am not sure about the diagnostic or the treatment and there is no endocrinologist in this town..
Could this be an infection of the thyroid? I have a very strange taste in my mouth, like a salty or acidic taste.
Posted Tue, 5 Nov 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Minal Mohit 1 hour later
Brief Answer:
Acute thyroiditis is infection of the thyroid

Detailed Answer:
Dear ma'm,


From your history, it seems that you may be having acute thyroiditis, which is an acute infection of the thyroid. It is a painful condition, with over-active thyroid which lasts for around 6 - 8 weeks.

Confirmative diagnosis of thyroiditis require radioactive thyroid scan.

Treatment of thyroiditis is usually pain killer, if it does not respond to pain killer then steroids (omnacortil) and beta blockers (inderal) are given. Only thing you did not mention is your thyroid function status. Please tell me that if possible and repeat your thyroid status after 6-8 weeks. Bitter taste in mouth is due to side effect of naproxen or even omnacortil.

Above answer was peer-reviewed by
Follow-up: Diagnosed with acute thyroiditis. Enlarged and swollen thyroid. Difficulty in swallowing and pain in back. Is it thyroid infection? 19 hours later
My thyroid report is as follows:
FT3 6.16
FT4 2.25
TSH 0.05
The ultra sound report says: both lobes of thyroid are bulky in size, heterogenous in echogenicity with lobulated contour and marked hyperemia on color dopler.
Right lobe measures 3.95x2.54 cm Left lobe:2.0x2.2 cm
The isthmus is enlarged with small ctsic lesion
Likely Dequervian thyroiditis.
My question is: why did the regular anti inflamatory medication (naproxen 250) i was first given did not work and i had to be given steroids. Is it possible that i have supurative thyroiditis which is an infection, not inflamation only. Then i would need antibiotics, not anti inflamatory med. and could the infection I had in the jaw bone have travelled to the thyroid ( via a sinus fistula)? I am concerned because I have had constant infection taste in the mouth since the tooth was extracted. ( this taste is different from the bitter taste given by the medicines- this is sort of salty, burning taste). Thank you for your help. With regards, XXXX
Answered by Dr. Minal Mohit 2 days later
Brief Answer:
Need to give more time and then review.

Detailed Answer:
Dear ma'm, first of all sorry for the delay in answering your query as I got stuck in meeting other deadlines. Now coming to your query, your reports are strongly suggestive of acute thyroiditis. many a times anti inflammatory drugs may take longer to provide relief. probably naproxen was not given sufficient time to show its effect. usually antibiotics are not indicated in acute thyroiditis , after NSAIDs steroids are the second choice. Inderal or ciplar can be added to both as symptomatic drug to control the symptoms of hyper secretion of thyroid hormones.

Suppurative thyroiditis is less likely as that would be easily picked up on Ultrasound also that will give you pain , fever, high blood count and high ESR.

Sinus fistula between jaws and thyroid and then secretions in mouth is more than hypothetical. Truly infections of oral cavity and throat can affect thyroid but fistula formation is not commonly known. There is a possibility that jaw infection might have spread to salivary glands and salivary ducts might be bringing infectious taste to your mouth.

I suggest wait for 6-8 weeks then repeat Thyroid function test, USG neck, CBC , ESR.

Above answer was peer-reviewed by
Follow-up: Diagnosed with acute thyroiditis. Enlarged and swollen thyroid. Difficulty in swallowing and pain in back. Is it thyroid infection? 1 hour later
Thank you Doctor XXXXXXX for your helpful answers.
I am much better after taking the steroids for 4 days now and the swelling and pain in the thyroid are greatly diminished.
The infectious taste in the mouth however is still just as strong as before. If indeed the jaw infection spread to the salivary glands and ducts, what is the treatment you recommend for that and also, is there a test that can be done to acertain whether it is the case?
Thank you. Regards.
Answered by Dr. Minal Mohit 34 minutes later
Brief Answer:
USG neck.

Detailed Answer:
Dear ma'm, hi! surely you need to know. you can undergo USG (ultrasonography) neck and must see your dentist for X-ray of the extracted tooth. Also try Pantocid 40 mg twice a day. regards!
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