Pseudo-giant cell arteritis

An 84-year-old man was admitted with 30-day history of fever with jaw claudication and diplopia. Physical examination did not reveal any abnormalities in the temporal artery. The erythrocyte sedimentation rate was 65 mm/h and the serum creatinine level was 1.23 mg/dl. Urinalysis revealed 1+ protein and 30-49 erythrocytes/high power field. Three sets of blood culture were negative. On admission day 5, we performed a temporal artery biopsy, suspecting giant cell arteritis from jaw claudication and diplopia.