acyclovir and Giant-Cell-Arteritis

Topics: Acyclovir; Adrenal Cortex Hormones; Adult; Baclofen; Calcium Channel Blockers; Carbamazepine; Cervical Vertebrae; Cluster Headache; Drug Therapy, Combination; Ergotamine; Eye Diseases; Facial Pain; Female; Giant Cell Arteritis; Headache; Humans; Lithium; Male; Methysergide; Middle Aged; Osteoarthritis; Otorhinolaryngologic Diseases; Psychotherapy; Psychotropic Drugs; Temporomandibular Joint Dysfunction Syndrome; Trigeminal Neuralgia; Vidarabine

The tongue is a common location for Horton necrotic injuries. But some herpetic lesions can show similar symptoms to the disease and complicate the diagnosis.. A 67-year-old woman, treated by corticosteroids for Horton disease, presented a central, deep, and very painful ulceration of the tongue. The spreading of necrosis despite treatment was an indication for biopsy, giving the diagnosis of herpetic infection. Valacyclovir was efficient within 15 days.. This necrotic injury looks like herpetic stomatitis presented by severely immunodeficient AIDS patients. No case under corticosteroids had been described so far. The tongue-limited location is exceptional.

Topics: Acyclovir; Aged; Antiviral Agents; Female; Giant Cell Arteritis; Glucocorticoids; Humans; Necrosis; Prednisone; Stomatitis, Herpetic; Tongue Diseases; Valacyclovir; Valine

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.

Topics: Acyclovir; Aged; Antiviral Agents; Biopsy; Diagnosis, Differential; Female; Giant Cell Arteritis; Herpes Zoster Ophthalmicus; Humans; Ophthalmic Nerve; Temporal Arteries; Valacyclovir; Valine

Topics: Acyclovir; Administration, Oral; Aged; Aged, 80 and over; Antiviral Agents; Conjunctivitis, Viral; Diagnosis, Differential; Female; Giant Cell Arteritis; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Nose; Polymerase Chain Reaction