This case demonstrates the importance of assessing patient risk factors for AST, even when clinical presentation may seem more typical of subacute thyroiditis. Prompt diagnosis with ultrasound-guided FNA and cultures may allow for targeted antibiotic therapy and prevent complications associated with AST. There is a lack of high-quality studies assessing the optimal management strategy for AST; as such, treatment should be guided by the severity of disease presentation. Further investigation is needed to assess the effectiveness of shorter courses of therapy and/or transition to oral antibiotics in less severe presentations showing early clinical improvement.