The presentation of a pig farmer with acute arthritis of the shoulder, cardiac murmurs, and Streptococcus suis growing on blood cultures highlights one of the rheumatological presentations of bacterial endocarditis. The need for a thorough general medical examination together with synovial fluid and blood culture in patients with acute monarthritis is emphasised. The suggestion that acute arthritis related to endocarditis is in nature truly septic, rather than mediated by circulating immune complexes, is supported.
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