PMC3638568_01
Patient's CT imaging showing a remarkable inflammatory process on the posterior portion of the neck and upper back. Note the accidental findings of diffusive enlargement of right lobe and isthmus of thyroid gland (see two black arrows) related to unrecognized subclinical goiter.
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fig1
The CT also showed a slightly enlarged right lobe and isthmus of the thyroid gland as an incidental finding (Figure 1). 
Enlarged area of necrotizing fasciitis in the posterior portion of the patient's neck and back. The area was exposed for long time to iodine-containing solutions.
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fig2
TSH, T4, and T3 serum levels during the patient's hospitalization stay. The timing of the CT scans, surgery, and treatment ( S:surgery, CT:CT scan, and T:treatment) is shown. It should be noted that all procedures were conducted with iodine-containing solutions.
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fig3
The patient underwent two additional CT scans of the head, neck, and chest with contrast iodine to guide surgical exploration (see Figure 3 for details).  T4 level PTU therapy was discontinued (see Figure 3). The patient was returned to the ENT department and two weeks later plastic surgery for wound closure was performed successfully.