ABSTRACT

Fever of unknown origin (FUO) means fever that does not resolve itself in the period expected for self-limited infection and whose cause cannot be ascertained despite considerable diagnostic efforts. The differential diagnosis is often different in older patients, and presentation of the disease is frequently nonspecific and symptoms are difficult to interpret. Multisystem disease has emerged as the most frequent cause of FUO in the elderly, and temporal arteritis is the most frequent specific diagnosis. Temporal arteritis (TA), also known as giant cell arteritis, is the most common vascu-litis in the elderly. It involves large and medium-sized blood vessels, with predispo-sition to the cranial arteries. Unlike visual complications, vestibular manifestations in TA, such as vertigo, have been poorly reported.We report a case of a 65-year-old woman with onset temporal arteritis presenting with fever, headache, night sweats, and especially positional vertigo symptoms. Her physical examination was normal. The work-up included a temporal artery biopsy, which showed marked lymphocytic infiltrate in the arterial wall consistent with TA (giant cell arteritis). We decided to present this case because of its unusual presenta-tion and the importance of early diagnosis and therapy