This almost always leads to a permanent cure of the condition. The dominant clinical symptom is pain in the region of the thyroid gland which may subsequently enlarge and become hot and tender. The patient is unable to extend the neck and often sits with the neck flexed in order to avoid pressure on the thyroid gland. Swallowing is painful. There are usually signs of infection in structures adjacent to the thyroid, local lymphadenopathy as well as temperature elevation and, if bacteremia occurs, chills.
Symptoms are generally more obvious in children than in adults.
Adults may present with a vague slightly painful mass in the thyroid region without fever, which may raise the possibility of a malignancy. It may occur more commonly in the fall and winter following upper respiratory tract infections. In general, there are no signs or symptoms of hyper- or hypothyroidism. However, exceptions to both have been reported particularly if the thyroiditis is generalized, such as occurs with fungal processes or mycobacterial infections. At times, even in patients with bacterial thyroiditis, destruction of the thyroid gland is sufficient to release thyroid hormone in amounts sufficient to cause symptomatic hyperthyroidism 8 .