A Twist in the Tale: The Unmasking of Listeria in a PMR Case.

In general, an older patient presenting with proximal muscle pain and fatigue, with elevated inflammatory markers, would generally result in an extensive evaluation. If this is negative, it would be reasonable for a diagnosis of polymyalgia rheumatica (PMR) to be made and the patient referred to rheumatology. Our patient presented myalgia in proximal muscles and an elevated sedimentation rate. He was treated with steroids for polymyalgia rheumatica with improvement. He was subsequently admitted to the intensive care unit (ICU), where a diagnosis of Listeria monocytogenes sepsis was made and treated. With antibiotics he improved and was discharged from the hospital. This Case Report underscores the importance of considering unusual infections when entertaining a systemic autoimmune rheumatic disease (SARD) as the cause of systemic inflammatory response syndrome.