Abstract

Introduction: Giant cell arteritis (GCA) is a subacute inflammatory panarteritis affecting the elderly. The clinical manifestations of this vasculitis are often progressive, combining cephalic, general, and systemic signs. A sudden onset mimicking an infectious disease may occur and should not lead to misdiagnosis in the elderly. Pseudo-septicemic forms are exceptional. We report an original and unusual sepsis-like presentation of GCA. Case Report: A 66-year-old woman, with no significant past medical history, was hospitalized for a fever of 39-40°C that had been present for 15 days. Her general condition was good, and the physical examination was unremarkable. Laboratory tests revealed a marked inflammatory syndrome with hyperleukocytosis. The search for direct or indirect signs of infection was negative, and broad-spectrum antibiotic therapy did not improve the patient’s condition. A temporal artery biopsy was performed and confirmed the diagnosis of GCA. Systemic corticosteroid therapy was initiated, and the patient’s condition improved rapidly. Conclusion: GCA can be mono- or pauci-symptomatic, presenting only as rheumatic, ocular, neuropsychiatric, pulmonary, neoplastic-like, sepsis-like, or biological manifestations. These atypical forms should not delay diagnosis in order to avoid serious ischemic complications of this disease.

Keywords

giant cell arteritis, sepsis-like, horton’s disease, sepsis, polymyalgia arteritica, vasculitis