A 55-year-old woman presents to her primary
care physician complaining of fever, headache,
and general malaise over the past 2 weeks. For
the past month, she has had recurrent headaches of increasing frequency. On further
questioning, the patient indicates that she has
felt feverish and generally “not well” for the
past 2 weeks. She denies any recent trauma, increase in stress, or known exposure to infection. Her temperature is 38.2°C (100.8°F),
heart rate is 92/min, and blood pressure is
114/85 mm Hg. On physical examination, the
patient has marked tenderness over her temples. The physician orders a stat erythrocyte
sedimentation rate level, and finds it to be
markedly increased at 109 mm/h. What is the
most likely diagnosis in this case?