# Giant Cell Arteritis With Sepsis-Like Symptoms in an Elderly Man: A Case Report

## TL;DR

An elderly man with sepsis-like symptoms was later diagnosed with giant cell arteritis, highlighting the need for careful diagnosis in similar cases.

## Contribution

The case highlights the diagnostic challenge of atypical giant cell arteritis presentations and management in elderly patients.

## Key findings

- Initial antibiotic treatment failed to resolve symptoms, leading to a revised diagnosis of giant cell arteritis.
- Steroid therapy significantly alleviated symptoms and prevented severe complications.
- The case emphasizes the importance of considering GCA in elderly patients with systemic inflammatory symptoms.

## Abstract

This case report details the diagnostic challenge and management of an 88-year-old man who presented to a rural Japanese community hospital with sepsis-like symptoms, initially suspected of acute bacterial cholangitis based on his physical and laboratory findings. Despite the antibiotic treatment of tazobactam and piperacillin, the patient's symptoms persisted, leading to further investigations that revealed no signs of infection but notable aortic arch wall thickening on contrast-enhanced computed tomography scans. These findings, combined with the patient's clinical presentation and lack of antibiotic response, redirected the diagnosis toward giant cell arteritis (GCA). The administration of prednisolone of 60 mg daily significantly alleviated symptoms and prevented potential severe complications such as blindness and irreversible neurological damage. This case underscores the importance of considering GCA in elderly patients presenting with systemic inflammatory symptoms and the necessity of timely intervention. It also highlights the challenges in managing high-dose steroid therapy in elderly patients and suggests the potential benefits of integrating immunosuppressants to reduce steroid dependency. This report emphasizes the need for heightened awareness and a comprehensive diagnostic approach in atypical presentations of GCA, particularly in geriatric populations within resource-limited healthcare settings.