This case highlights the importance of considering ANCA-negative granulomatosis with polyangiitis (GPA) in patients with nonspecific symptoms with multisystem involvement, including pulmonary, skin, and constitutional symptoms, even in the absence of classical serologic markers after ruling out infectious causes mimicking the presentations in resource-limited settings. A multidisciplinary approach and tissue biopsy are crucial for early diagnosis and initiation of treatment, which can significantly improve outcomes.