Assuntos
Aranha Marrom Reclusa , Edema da Córnea/diagnóstico , Endotélio Corneano/imunologia , Sistema Imunitário/patologia , Picada de Aranha/diagnóstico , Transtornos da Visão/diagnóstico , Animais , Antibacterianos/uso terapêutico , Edema da Córnea/tratamento farmacológico , Dexametasona/uso terapêutico , Combinação de Medicamentos , Endotélio Corneano/efeitos dos fármacos , Glucocorticoides/uso terapêutico , Humanos , Sistema Imunitário/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Picada de Aranha/tratamento farmacológico , Tobramicina/uso terapêutico , Transtornos da Visão/tratamento farmacológicoRESUMO
PURPOSE: To present a case of herpes zoster vasculitis presenting as giant cell arteritis. DESIGN: Interventional case report. METHODS: A 77-year-old woman presented with sudden onset of diplopia associated with temple headaches and a previous history of herpes zoster ophthalmicus. A temporal artery biopsy was obtained and in-situ hybridization performed for herpes zoster DNA. RESULTS: The patient presented with a bilateral internuclear ophthalmoplegia. Initial diagnostic evaluation, including erythrocyte sedimentation rate, C-reactive protein, and temporal artery biopsy, was consistent with giant cell arteritis. However, in-situ hybridization of the temporal artery specimen was positive for herpes zoster DNA. CONCLUSIONS: Herpes zoster vasculitis may mimic giant cell arteritis and should be considered in the differential of any patient with presumed giant cell arteritis with suspicious findings, central nervous system involvement, or previous herpes zoster infection.
