title: Misdiagnoses: a timely reminder.
abstract: This case report of an occult infection masquerading as palindromic arthritis was misdiagnosed for almost 2 years. The episodic bouts of erysipelas were not obvious, and it was even suggested that the silicone implanted 7 years previously could possibly be inciting an autoimmune disease. Approximately 2 years after the onset of the recurrent episodes of fever, myalgias, and arthralgias, coagulase-negative staphylococci were found residing in the valve stems of bilumen breast implants, which were removed. The symptom complex disappeared and has not recurred.
authors.affiliation: Department of Surgery, Oregon Health Sciences University, Portland.
authors.forename: W R
authors.initials: WR
authors.lastname: Marshall
authors.forename: J E
authors.initials: JE
authors.lastname: Leggett
mesh_terms: D000328:Adult; D001168:Arthritis / Q000175:diagnosis*; D001327:Autoimmune Diseases / Q000175:diagnosis; D001424:Bacterial Infections / Q000175:diagnosis*; D003951:Diagnostic Errors; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects*; D019736:Prostheses and Implants / Q000009:adverse effects*; D012008:Recurrence; D012828:Silicones / Q000009:adverse effects*; D013203:Staphylococcal Infections / Q000175:diagnosis; D013210:Staphylococcus / Q000302:isolation & purification; D013997:Time Factors
chemical_list: D012828:Silicones