Background: Subacute thyroiditis (SAT) is a rare inflammatory disease of the thyroid gland. It has been noticed that patients with a diagnosis of SAT visit more other clinics and receive antibiotics unnecessarily. Therefore, the aim of this study was to reveal the degree of delay in the diagnosis of SAT, prediagnosis antibiotic use rates, and the awareness of clinics for the diagnosis of SAT. Methods: A total of 121 patients with SAT were enrolled in the study. A retrospective analysis was made of the history of patient symptoms during the diagnosis, which physicians they visited, antibiotic use, laboratory test results, and ultrasonographic findings. Results: The median age of the patients was 41 years. Neck pain radiating to the jaw/ear was seen in most patients (71.1%). The median time from symptom onset to a diagnosis of SAT was 23 days (range, 6–70 days). Antibiotics were erroneously prescribed to 71 patients (58.7%) before the diagnosis. The median time to diagnosis was 28 days in patients using antibiotics and 20 days in the group not using antibiotics (p #x3c; 0.001). Two or more physicians had been visited before SAT diagnosis by 89 (73.6%) patients, and more antibiotics were prescribed to these patients than the group who visited fewer physicians (p #x3c; 0.05). The frequency of prescribing antibiotics by physicians was 73.7% by emergency physicians, 53.1% by family doctors, 51.1% by ENT specialists, and 35.4% by internal medicine specialists. Conclusion: The diagnosis of SAT is often delayed, and misdiagnosis leads to erroneous antibiotic overuse. Physicians should increase their awareness of the diagnosis of SAT in patients with neck pain.
Eur Thyroid J

中文翻译：

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亚急性甲状腺炎治疗中的两个重要问题：延误诊断和不当使用抗生素

背景：亚急性甲状腺炎（SAT）是一种罕见的甲状腺炎性疾病。人们注意到，诊断为 SAT 的患者会去更多的其他诊所并不必要地接受抗生素治疗。因此，本研究的目的是揭示 SAT 诊断的延迟程度、诊断前抗生素使用率以及诊所对 SAT 诊断的认识。方法：共有 121 名 SAT 患者参加了该研究。回顾性分析了患者在诊断期间的症状史、他们就诊的医生、抗生素使用情况、实验室检查结果和超声检查结果。结果：患者的中位年龄为 41 岁。大多数患者（71.1%）可见颈部疼痛放射至下颌/耳朵。从症状出现到诊断为 SAT 的中位时间为 23 天（范围为 6-70 天）。诊断前 71 名患者 (58.7%) 被错误地开具了抗生素处方。使用抗生素的患者中位诊断时间为 28 天，未使用抗生素组为 20 天（p #x3c；0.001）。89 名 (73.6%) 患者在 SAT 诊断前曾拜访过两名或两名以上的医生，并且这些患者的抗生素处方量高于就诊次数较少的组（p#x3c; 0.05)。医生开抗生素的频率是急诊医生的 73.7%，家庭医生的 53.1%，耳鼻喉科专家的 51.1%，内科专家的 35.4%。结论： SAT的诊断往往延误，误诊导致误用抗生素。医师应提高对颈部疼痛患者 SAT 诊断的认识。
欧洲甲状腺杂志