De Socio Giuseppe Vittorio L, Mencacci Antonella, Bini Paolo, Pasticci Maria Bruna
Department of Infectious Diseases Santa Maria della Misericordia Hospital, University of Perugia, Italy.
South Med J. 2009 Oct;102(10):1082-4. doi: 10.1097/SMJ.0b013e3181b4e5b8.
A case of Fusobacterium nucleatum endocarditis in an 80-year-old man is reported. The patient presented with a headache and nonspecific musculoskeletal symptoms and was misdiagnosed as having polymyalgia rheumatica. The diagnosis of bacterial endocarditis was delayed because of an insidious presentation, typical in infections with low virulence micro-organisms. The musculoskeletal symptoms, unresponsive to protracted corticosteroids, completely resolved with intravenous ampicillin treatment. Rheumatologic symptoms may hinder the correct diagnosis of subacute infective endocarditis. An atypical evolution of a common rheumatic disorder such as polymyalgia rheumatica should alert physicians to the possibility of bacterial endocarditis.
报告了一例80岁男性感染具核梭杆菌性心内膜炎的病例。该患者出现头痛和非特异性肌肉骨骼症状，被误诊为风湿性多肌痛。由于病情隐匿，这在低毒力微生物感染中很典型，细菌性心内膜炎的诊断被延迟。对长期使用皮质类固醇无反应的肌肉骨骼症状，经静脉注射氨苄青霉素治疗后完全缓解。风湿性症状可能会妨碍亚急性感染性心内膜炎的正确诊断。常见风湿性疾病如风湿性多肌痛的不典型演变应提醒医生注意细菌性心内膜炎的可能性。
