Subacute bacterial endocarditis presenting as polymyalgia rheumatica or giant cell arteritis

Clinical and Experimental Rheumatology

D. Le Thi Huong¹  P. Cacoub¹  A. Sbai¹  T. Papo¹  F. Lhote¹  J.-C. Piette¹  X. Delarbre¹  C. Martin-Hunyadi¹  B. Wechsler¹  C. Auzary¹ 

关键词: Polymyalgiarheumatica;    giant cell arteritis;    infective endocarditis.;   

DOI  :  

学科分类：医学（综合）

来源: Pacini Editore SpA

【 摘 要 】

OBJECTIVES: To report on several patients with subacute bacterial endocarditis who were initially presumed, incorrectly, to have polymyalgia rheumatica or giant cell arteritis.METHODS:We report 3 cases of subacute streptococcal endocarditis mimicking giant cell arteritis in 2 cases and polymyalgia rheumatica in one. We reviewed the literature through Medline search of French and English-language articles published between 1966 and 2005 and found 5 similar cases.RESULTS:Shoulder and/or pelvic girdle pain was associated with neck or back pain in all patients. Scalp tenderness, bilateral jaw pain, amaurosis fugax were present in 2 patients. One patient had no fever. Two patients were treated with corticosteroids with initial good clinical response in one. Appropriate antibiotic therapy resulted in the rapid disappearance of rheumatic complaints in 2 patients and achieved a definitive cure of endocarditis in all cases.CONCLUSIONS:Rheumatologic symptoms may hinder the correct diagnosis of infective endocarditis in patients who present with a clinical picture suggesting polymyalgia rheumatica or giant cell arteritis. In such cases, blood cultures should be systematically drawn.

【 授权许可】

Unknown