Treating malignant otitis with oral ciprofloxacin.

Comment A fatal outcome in patients with giant cell arteritis has been poorly recognised, and previous reports have generally been case reports or necropsy studies.4 The necropsy rate is low in many countries, and microscopic examinations of arteries in patients dying from vascular disorders are not routine, especially in elderly people. Hence, giant cell arteritis may be concealed among the cases currently diagnosed as ischaemic catastrophes due to arteriosclerosis. There is a general consensus that all patients with giant cell arteritis should be treated with corticosteroids. As well as rapidly relieving clinical symptoms, such treatment may prevent ischaemic ophthalmic catastrophes.5 Our findings indicate that corticosteroids may also prevent other ischaemic lesions. Our results show that patients with giant cell arteritis run an increased risk of dying from vascular disorders in the initial phase of the disease. After four months, following the start of corticosteroid treatment, the risk equalled that of the general population.