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May 1980

Inflammation of the Temporal Artery Associated With Subacute Bacterial Endocarditis and Hepatitis B Antigen

Author Affiliations

From the Division of Neuropathology, University of Maryland Hospital, Baltimore. Dr Garcia is now with the University of Alabama Medical Center, Birmingham.

Arch Neurol. 1980;37(5):318. doi:10.1001/archneur.1980.00500540096020

Two patients complained of tender temporal nodules, and biopsy disclosed temporal arteritis associated with subacute bacterial endocarditis and hepatitis B polyarteritis, respectively.

REPORT OF CASES  CASE 1.—A 63-year-old man had a diagnosis of mitral and aortic stenosis nine months before the present admission, later, amaurosis fugax developed. Five days after a dental procedure, he noticed a painful nodule over his right temple and visual obscurations in the right eye.Fig 1.—Biopsy specimen of temporal artery (case 1) showing occlusion of lumen by organizing thrombus and inflammation of wall (arrow). There is also inflammation of connective tissue adjacent to artery (arrowhead) (hematoxylin-eosin, original magnification ×2) 2).On admission, blood pressure was 140/60 mm Hg, pulse rate was 90 beats per minute, and temperature was 38.7 °C. A firm, pulsatile, tender right temporal nodule was felt. There were retinal hemorrhages on the right. The ESR was 39 mm/hr.The patient received prednisone.