Headache and vision changes in an elderly man with rheumatoid arthritis

Int J Rheum Dis. 2019 Jul;22(7):1331-1334. doi: 10.1111/1756-185X.13589. Epub 2019 May 22.

Abstract

We present a case of an elderly, immunosuppressed patient with rheumatoid arthritis who was not appropriately vaccinated, and subsequently developed herpes zoster ophthalmicus, which initially presented similar to giant cell arteritis. Evidence-based vaccinations are integral in decreasing the incidence of preventable diseases and promoting optimal health at the individual and population level. Although the patient ultimately did not suffer any long-term adverse sequelae, this case highlights the importance of vaccination in the rheumatology setting, and to consider both inflammatory and infectious causes of headache and vision changes in the elderly.

Keywords: giant cell arteritis; herpes zoster ophthalmicus; rheumatology; vaccination.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antirheumatic Agents / adverse effects*
  • Antiviral Agents / therapeutic use
  • Arthritis, Rheumatoid / diagnosis
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / immunology
  • Headache / diagnosis
  • Headache / drug therapy
  • Headache / immunology
  • Headache / virology*
  • Herpes Zoster Ophthalmicus / diagnosis
  • Herpes Zoster Ophthalmicus / drug therapy
  • Herpes Zoster Ophthalmicus / immunology
  • Herpes Zoster Ophthalmicus / virology*
  • Herpesvirus 3, Human / drug effects
  • Herpesvirus 3, Human / immunology
  • Herpesvirus 3, Human / pathogenicity*
  • Humans
  • Immunocompromised Host
  • Male
  • Opportunistic Infections / diagnosis
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / immunology
  • Opportunistic Infections / virology*
  • Treatment Outcome
  • Vision Disorders / diagnosis
  • Vision Disorders / drug therapy
  • Vision Disorders / immunology
  • Vision Disorders / virology*

Substances

  • Antirheumatic Agents
  • Antiviral Agents