A young black Jordanian lady who has type one diabetes, chronic diabetic complication and ischemic heart disease, presented with a picture of diabetic keto-acidosis, precipitated by an acute neck swelling. This was suggestive of acute suppurative thyroiditis with abscess formation causing compressive symptoms. This unfortunate patient had an eventful course despite aggressive treatment by antibiotics and surgery and then succumbed of an acute cardiac event. The operative tissue biopsy revealed an abscess in an infarcted papillary thyroid cancer. We believe this is a rare presentation of such an association with a fatal outcome.

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