Herpes zoster ophthalmicus: presenting as giant-cell arteritis.
A 74-year-old woman was referred to the authors' clinic with a 1-week suspicion of giant-cell arteritis. Uncomplicated, bilateral temporal artery biopsies were performed 3 days after admission for therapy. Four hours after the procedure she developed vesicular lesions of the face compatible with herpes zoster ophthalmicus. The temporal artery biopsy revealed perineural lymphocytic aggregation. Both giant-cell arteritis and herpes zoster ophthalmicus form part of the differential diagnosis in elderly patients with headache. In such cases, clues from a temporal artery biopsy may aid in diagnosis of herpes zoster. In addition, the patient in this case developed the rash 10 days after onset of symptoms, which is rare as the average time from onset of symptoms to rash in zoster is 3-5 days.
de Castro
Luis E Fernández
LE
Magill Research Center for Vision Correction, Storm Eye Institute, Medical University of South Carolina, Charleston, SC 29425, USA.
Petersen
Aaron M
AM
Givre
Syndee J
SJ
Solomon
Kerry D
KD
Vroman
David T
DT
D000212:Acyclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis*; D006563:Herpes Zoster Ophthalmicus / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D009882:Ophthalmic Nerve / Q000473:pathology; D013699:Temporal Arteries / Q000473:pathology*; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use
D000998:Antiviral Agents; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir