title: Herpes zoster vasculitis presenting as giant cell arteritis with bilateral internuclear ophthalmoplegia.
abstract: OBJECTIVE
  To present a case of herpes zoster vasculitis presenting as giant cell arteritis.
  
  
  METHODS
  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.
authors.affiliation: Wilmer Eye Institute, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
authors.forename: Nael A
authors.initials: NA
authors.lastname: Al-Abdulla
authors.forename: Vivian
authors.initials: V
authors.lastname: Rismondo
authors.forename: John S
authors.initials: JS
authors.lastname: Minkowski
authors.forename: Neil R
authors.initials: NR
authors.lastname: Miller
mesh_terms: D000368:Aged; D004279:DNA, Viral / Q000032:analysis; D003937:Diagnosis, Differential; D004172:Diplopia / Q000209:etiology; D005133:Eye Movements; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000209:etiology; D006261:Headache / Q000209:etiology; D006563:Herpes Zoster Ophthalmicus / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D017403:In Situ Hybridization; D015835:Ocular Motility Disorders / Q000175:diagnosis* / Q000209:etiology; D013699:Temporal Arteries / Q000473:pathology / Q000821:virology; D014792:Visual Acuity
chemical_list: D004279:DNA, Viral