Infective endocarditis presenting as polymyalgia rheumatica: case report / polimiyaljiya romatikayi taklit eden infektif endokardit: olgu sunumu

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Authors: Cihat Ozturk, Selcen Ozdedeli, Yasemin Cinar and Meral Kayikcioglu
Date: June 2011
From: Turkish Journal of Rheumatology(Vol. 26, Issue 2)
Publisher: Turkish League Against Rheumatism
Document Type: Article
Length: 2,496 words

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Infective endocarditis is a bacterial infection of the cardiac valves and endocardium with a high level of mortality and morbidity. Due to such high mortality and morbidity risks, early and accurate diagnosis bears great importance. Accordingly, for prevention of wrong or delayed diagnosis and treatment, it is important to know and be aware of diseases that can be mimicked by infective endocarditis and to keep such diseases in mind in the assessment and evaluation of the patient. In patients suffering from infective endocarditis, the disease may be accompanied by rheumatological symptoms and manifestations such as myalgia, arthralgia and arthritis. A review of the existing medical literature reveals a few cases of infective endocarditis mimicking polymyalgia rheumatica. In this article, we present a 64-year-old male case of infective endocarditis mimicking polymyalgia rheumatica without any known predisposing factor for infective endocarditis.

Key words: Echocardiography; infective endocarditis; polymyalgia rheumatica.

Infektif endokardit, kalp kapaklari ve endokardin mortalite ve morbidite seviyesi yuksek bir bakteriyel infeksiyonudur. Bu yuksek mortalite ve morbidite nedeniyle erken ve dogru tani buyuk onem tasimaktadir. Buna uygun sekilde, infektif endokarditin taklit edebilecegi hastaliklarin bilinmesi ve bunlarin farkinda olunmasi ve hastanin degerlendirilmesi sirasinda bu gibi hastaliklarin akilda bulundurulmasi yanlis ya da gecikmis tani ve tedavinin onlenmesinde onemlidir. cnfektif endokarditten yakinan hastalarda hastaliga miyalji, artralji ve artrit gibi romatolojik semptomlar ve belirtiler eslik edebilir. Mevcut tibbi literatur incelendiginde, polimiyaljiya romatikayi taklit eden cok az sayida infektif endokardit olgusu bulundugu goruldu. Bu yazida, infektif endokardite egilim yarattigi bilinen herhangi bir faktore sahip olmayan ve polimiyaljiya romatikayi taklit eden infektif endokarditli 64 yasinda bir erkek hasta sunuldu.

Anahtar sozcukler: Ekokardiyografi; infektif endokardit; polimiyaljia romatika.

Infective endocarditis (IE) is a bacterial infection of the heart valves and endocardium. Bacterial endocarditis may present itself with rheumatological symptoms in 28-42% of patients.[1-3] The most common musculoskeletal manifestation is myalgia, followed up arthralgia and peripheral arthritis, though this is seen more rarely.[3] There are few cases of infective endocarditis mimicking polymyalgia rheumatica (PMR) reported in the literature.

CASE REPORT

A 64-year-old man was admitted to our clinic with complaints of pain in his neck, shoulders and pelvis girdle. His symptoms had begun about two months previously and had become more intense and severe over time. The pains were reported to diminish with mobility, but no change was reported while resting. The pains were accompanied by morning stiffness which continued until afternoon. His systemic inquiry did not reveal any disease symptoms relating to his cardiopulmonary, gastrointestinal and genitourinary systems. The patient also hasn't suffered any trauma, arthralgia, arthritis, headache, mandibular claudication or visual problems recently.

About three months before admission to our clinic, the patient had intermittent fever episodes accompanied by a weight loss of 3 kg in three months. In the hospital where he went because of these complaints, he was diagnosed with Brucellosis and was, therefore, given an empiric antibiotic treatment. As a result, his fever episodes did not recur. The patient was on regular medication for hypertension and coronary artery disease.

In his physical examination, his body temperature...

Source Citation

Source Citation
Ozturk, Cihat, et al. "Infective endocarditis presenting as polymyalgia rheumatica: case report / polimiyaljiya romatikayi taklit eden infektif endokardit: olgu sunumu." Turkish Journal of Rheumatology, vol. 26, no. 2, 2011, p. 154+. Accessed 23 Oct. 2020.
  

Gale Document Number: GALE|A292993907