7 ）M e y e r s O L , C o m m e r f o r d P J : M u s c u l o s k e l e t a l
1 ）Li JS, Sexton DJ, Mick N, et al: Proposed modifications to
manifestations of bacterial endocarditis. Ann Rheum Dis,
36: 517－519, 1977.
the Duke criteria for the diagnosis of infective
8 ）Dajani AS, Taubert KA, Wilson W, et al: Prevention of
endocarditis. Clin Infect Dis, 30: 633－638, 2000.
2 ）中澤 誠，石和田稔彦，市田蕗子，他 : 小児心疾患
bacterial endocarditis. Recommendations by the
と成人先天性心疾患における感染性心内膜炎の管
American Heart Association. JAMA, 277: 1794 － 1801,
理．治療と予防ガイドライン【ダイジェスト版】
．日
1997.
小児循環器会誌，28: 6 －39，
2012．
9 ）Garric M, Boumaza X, Paricaud K, et al: Febrile myalgia
3 ）中谷 敏，芦原京美，泉 知里，他 : 感染性心内膜
revealing propionibacterium acnes endocarditis. Rev Med
炎の予防と治療に関するガイドライン（2017年改訂
Interne, 40:613－616, 2019.
版）．一般社団法人日本循環器学会．https://www.
10）Louria DB, Sen P, Kaplla R, Johnson E, Smith L, Roberts
j-circ.or.jp/cms/wp-content/uploads/2017/07/JCS2017_
R: Anterior thigh pain or tenderness. A diagnostically
nakatani_h.pdf.
useful manifestation of bacteremia. Arch Intern Med,
4 ）Crum-Cianflone NF: Bacterial, fungal, parasitic, and viral
145: 657－658, 1985.
11）佐々木征行 : 画像診断の意義．小児内科，48: 1887－
myositis. Clin Microbiol Rev, 21: 473－494, 2008.
5 ）Churchill MA Jr, Geraci JE, Hunder GC: Musculoskeletal
manifestations of bacterial endocarditis. Ann Intern Med,
1892，2016．
12）Mercuri E, Pichiecchio A, Allsop J, Messina S, Pane M,
87: 754－759, 1977.
Muntoni F: Muscle MRI in inherited neuromuscular
6 ）Llinas L, Harrington T: Musculoskeletal manifestations as
the initial presentation of infective endocarditis. South
disorders: past, present, and future. J Magn Reson
Imaging, 25: 433－440, 2007.
Abstract
A CASE DIAGNOSED AS INFECTIVE ENDOCARDITIS WHICH SUFFERED
FROM DIFFICULTY IN WALKING DUE TO MYALGIA OF BOTH OF THIGHS
Soichiro Tanimura 1 ）, Ryosuke Fukushima 2 ）
1）
Department of Pediatrics, Children’s medical center, Fujisawa City Hospital
2）
Department of Pediatric Emergency Medicine, Emergency and Critical care center, Fujisawa City Hospital
Infective endocarditis is a disease with high urgency and severity. Common symptoms include fever, loss of
appetite, weight loss, and fatigue; however, they are nonspecific and diverse symptoms are observed. A nine-year-old
female patient with chief complaints of fever and bilateral thigh myalgia that caused difficulty in walking was
referred to our department. She had developed a fever of over 38℃ on the first day of the illness. Difficulty in
walking was experienced on the third day of the illness due to myalgia in the thighs. She was referred to our
department for the purpose of detailed examination and treatment on the fifth day of the illness as the cause remained
unknown and no improvement was observed. After detailed examination at our hospital, the patient was diagnosed
with acute infective myositis and was admitted to our hospital for the purpose of rest and antimicrobial treatment.
After admission, methicillin-sensitive Staphylococcus aureus was detected in the culture of the blood sample that
had been obtained at the time of presentation to our hospital. Upon searching for the cause of bacteremia, infective
endocarditis was diagnosed by cardiac ultrasonography. In patients who present with fever and myalgia, it is
important to consider infective endocarditis among the differential diagnoses.
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