Differential Diagnosis for Blurry Vision, Vasculitis, Fever, and Hypertension
Single Most Likely Diagnosis
- Giant Cell Arteritis (GCA): This condition is a large vessel vasculitis that can cause blurry vision due to ischemic optic neuropathy, fever, and hypertension. The combination of these symptoms, especially in an older adult, makes GCA a leading consideration.
Other Likely Diagnoses
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis, GPA): This is a small vessel vasculitis that can affect multiple organs, including the eyes, causing blurry vision, and is often associated with fever and hypertension.
- Polyarteritis Nodosa (PAN): A medium vessel vasculitis that can cause a wide range of symptoms including fever, hypertension, and visual disturbances due to vasculitis affecting various organs.
- Systemic Lupus Erythematosus (SLE): An autoimmune disease that can cause vasculitis, fever, hypertension, and a variety of ocular symptoms including blurry vision.
Do Not Miss Diagnoses
- Central Retinal Artery Occlusion: Although not primarily a vasculitis, this condition can cause sudden blurry vision and is an ocular emergency. It may be associated with systemic conditions like hypertension and could be a complication of vasculitis.
- Endocarditis: Infective endocarditis can cause fever, vasculitis (e.g., Janeway lesions), and embolic phenomena that might lead to visual disturbances. It's crucial due to its high mortality if untreated.
- Malignant Hypertension: Severe, uncontrolled hypertension can lead to hypertensive emergencies, including vision loss due to hypertensive retinopathy or optic neuropathy.
Rare Diagnoses
- Eales Disease: A rare idiopathic condition characterized by retinal vasculitis and neovascularization, which can cause blurry vision. It's more common in young adults and might not fully explain the systemic symptoms like fever and hypertension.
- Susac Syndrome: A rare autoimmune endotheliopathy affecting the brain, retina, and inner ear, causing a distinct set of symptoms including vision loss. It's less likely given the broader systemic symptoms but is a unique consideration in cases of unexplained vasculitis and visual disturbances.
- Primary Central Nervous System Vasculitis (PCNSV): A rare form of vasculitis confined to the central nervous system, which can cause a variety of neurological symptoms including visual disturbances. It might not directly cause systemic symptoms like fever and hypertension but could be considered in complex cases.