[Temporal arteritis: a confounding diagnosis]

Temporal arteritis is a chronic vasculitis of medium and large-size vessels and involves particularly extracranial branches of the aortic arch arteries. Authors report the case of a 73-year-old woman who presented to the hospital after looking for medical counselling three times because of unexplained fever, fatigue, nonproductive cough, and throat pain. She already completed two antibiotic prescriptions. This 3-week history completed in the last days with temporal bilateral headache and visual disturbance. Physical examination was notable for fever and bilateral thickened tender temporal arteries. The erythrocyte sedimentation rate was elevated. A biopsy specimen of the left temporal artery confirmed the diagnosis of giant cell temporal arteritis. The diagnostic suspicion of this disease is clinical and usually simple, but in 10% there are throat pain, non-productive cough and fever which are misunderstood as superior respiratory tract infections leading to diagnosis and treatment delay.