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Published on: February 8, 2019

Subacute bacterial endocarditis presenting as polymyalgia rheumatica or giant cell arteritis

C Auzary1, D Le Thi Huong, X Delarbre

  • 1Department of Internal Medicine, Centre Hospitalier Moulins-Yzeure, Moulins, France. c.auzary@ch-moulins-yzeure.fr

Clinical and Experimental Rheumatology
|July 25, 2006
PubMed
Abstract

Insights

Subacute bacterial endocarditis can mimic polymyalgia rheumatica and giant cell arteritis, leading to misdiagnosis. Prompt blood cultures are crucial for accurate diagnosis and timely antibiotic treatment of infective endocarditis.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Subacute bacterial endocarditis (SBE) can present with non-specific symptoms.
  • Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are common rheumatologic conditions in older adults.

Observation:

  • Three cases of SBE mimicking PMR or GCA are presented.
  • A literature review identified five additional similar cases.
  • Patients presented with shoulder and/or pelvic girdle pain, often with neck or back pain.

Findings:

  • Two patients with SBE initially presented with symptoms suggestive of GCA, and one with symptoms of PMR.
  • Some patients experienced scalp tenderness, jaw pain, or transient vision loss.
  • Corticosteroid treatment provided temporary relief in one patient.
  • Antibiotic therapy led to rapid resolution of rheumatic symptoms and cure of endocarditis.

Implications:

  • Rheumatologic symptoms can obscure the diagnosis of infective endocarditis.
  • Systematic blood cultures are essential in patients with suspected PMR or GCA who have atypical features.
  • Early diagnosis and appropriate antibiotic treatment are critical for managing SBE.

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