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Wegener’s granulomatosis mimicking a parotid abscess

Published online by Cambridge University Press:  08 March 2006

G L Jones
Affiliation:
Department of Otorhinolaryngology, Royal Gwent Hospital, Newport, Wales.
A D Lukaris
Affiliation:
Department of Ophthalmology, University Hospital of Wales, Cardiff, Wales.
H V Prabhu
Affiliation:
Department of Otorhinolaryngology, Royal Gwent Hospital, Newport, Wales.
M J K M Brown
Affiliation:
Department of Otorhinolaryngology, Royal Gwent Hospital, Newport, Wales.
J Bondeson
Affiliation:
Department of Rheumatology, University Hospital of Wales, Cardiff, Wales

Abstract

We present the case of a previously healthy 59-year-old man who was under treatment for scleritis and episcleritis when he developed a parotid-gland swelling and pus-producing sinus. On surgical exploration, the features were those of a parotid abscess, but the lesion not only failed to heal post-operatively but increased in size very significantly. There was also severe necrotizing keratitis of the eyes. Due to clinical suspicion and a positive antineutrophil cytoplasmic antibodies test, Wegener’s granulomatosis was diagnosed and the patient successfully treated with cyclophosphamide and steroids. Previously, a number of cases of Wegener’s granulomatosis causing salivary-gland swelling have been reported in the literature; this is the first case in which the disease has masqueraded as a parotid abscess.

Type
Research Article
Copyright
© 2005 Royal Society of Medicine Press

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