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Case report
Granulomatosis with polyangiitis manifesting as fever of unknown origin
  1. Faisal Mahfooz1,
  2. Douglas Duffee1 and
  3. Rupal Chavda2
  1. 1Internal Medicine, Parkview Medical Center, Pueblo, Colorado, USA
  2. 2Rheumatology, Parkview Medical Center, Pueblo, Colorado, USA
  1. Correspondence to Dr Douglas Duffee; douglas_duffee{at}parkviewmc.com

Abstract

Fever of unknown origin (FUO) has a broad differential diagnosis, including infectious, inflammatory and malignant aetiologies. Granulomatosis with polyangiitis (GPA) can present with non-specific symptoms, including fever, lethargy and flu-like illness. While systemic vasculitis causing FUO has been well-documented, GPA as an underlying cause for FUO poses a diagnostic and therapeutic challenge for clinicians. We present the case of a 65-year-old man who presented to the emergency department with a report of fever, myalgia and night sweats for greater than 3 weeks. After an extensive workup, the patient was diagnosed with GPA and he eventually responded to corticosteroids and immunosuppressive therapy. This case aims to raise awareness of FUO secondary to GPA and serves as a reminder to clinicians that early recognition and prompt treatment of this syndrome improves patient outcomes.

  • vasculitis
  • medical education
  • medical management

https://doi.org/10.1136/bcr-2020-239713

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    Footnotes

    • Contributors FM: As primary author, contributed fully to real-time patient care, planning, conduct and reporting of the paper. DD: As mentor to the primary author, contributed fully to oversight of real-time patient care, planning, conduct and proofreading with substantial editing of the paper. RC: As treating rheumatologist, contributed to oversight and management of the rheumatologic real-time patient care and proofreading of the article for technical accuracy and editing.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer-reviewed.