A 30-year-old woman comes to the physician with fever and malaise. For the past two days, she has felt fatigued and weak and has had chills. Last night, had a temperature of 40.8°C (104.2°F). She has had a sore throat since this morning. The patient was recently diagnosed with Graves disease and started on an antithyroid medication. Physical examination shows an erythematous pharynx and a normal-sized thyroid. There is no tremor of the outstretched hands. Which of the following is the most likely cause of this patient's current condition?

Question

A 30-year-old woman comes to the physician with fever and malaise. For the past two days, she has felt fatigued and weak and has had chills. Last night, had a temperature of 40.8°C (104.2°F). She has had a sore throat since this morning. The patient was recently diagnosed with Graves disease and started on an antithyroid medication. Physical examination shows an erythematous pharynx and a normal-sized thyroid.  There is no tremor of the outstretched hands.  Which of the following is the most likely cause of this patient's current condition?

Quizplus · Accepted Answer

Eductional Objective: Agranulocytosis is a serious complication of antithyroid drugs (eg, methimazole, propylthiouracil) that results from drug-induced granulocyte destruction and consequent neutropenia.  Initial manifestations often include fever, sore throat, and oral ulcerations.  If drug-induced agranulocytosis is suspected, the drug should be discontinued immediately and a complete blood count with differential should be obtained to help confirm the diagnosis.

A 30-Year-Old Woman Comes to the Physician with Fever and Malaise