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Wegener's granulomatosis mimicking skull base osteomyelitis

Published online by Cambridge University Press:  16 August 2011

A Sharma ,
S Deshmukh ,
A Shaikh  and
J Dabholkar
A Sharma*
Affiliation:
Department of Otorhinolaryngology and Head-Neck Services, Seth G S Medical College, King Edward VII Memorial Hospital, Mumbai, India
S Deshmukh
Affiliation:
Department of Otorhinolaryngology and Head-Neck Services, Seth G S Medical College, King Edward VII Memorial Hospital, Mumbai, India
A Shaikh
Affiliation:
Department of Otorhinolaryngology and Head-Neck Services, Seth G S Medical College, King Edward VII Memorial Hospital, Mumbai, India
J Dabholkar
Affiliation:
Department of Otorhinolaryngology and Head-Neck Services, Seth G S Medical College, King Edward VII Memorial Hospital, Mumbai, India
*
Address for correspondence: Dr Arpit Sharma, Assistant Professor, Department Of Otorhinolaryngology and Head-Neck Services, Seth G S Medical College, KEM Hospital, Parel, Mumbai 400012, India E-mail: dr_arpit_sharma@hotmail.com
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Abstract

Objective:

To report a case of Wegener's granulomatosis mimicking skull base osteomyelitis.

Case report:

A case of Wegener's granulomatosis is reported in a diabetic woman presenting with facial palsy and hearing loss. The clinical course of the disease was very similar to that of skull base osteomyelitis, especially since the patient was diabetic and the ear swab was positive for pseudomonas. The definitive diagnosis was made based on clinical presentation, imaging and serum antineutrophil cytoplasmic antibody testing. The patient was started on immunosuppressants, and her hearing loss and facial palsy recovered.

Conclusion:

Wegener's granulomatosis is a systemic disease with various manifestations. A high index of clinical suspicion is required to reach the correct diagnosis. The clinician should be alerted to the possibility of Wegener's granulomatosis in the presence of: systemic upset out of proportion to the apparent intensity of the local lesion; middle-ear disease failing to respond to conventional treatment; and a consistently raised erythrocyte sedimentation rate.

Keywords

Wegener's GranulomatosisOtitis ExternaOsteomyelitisAntibodiesAntineutrophil CytoplasmicHearing LossFacial Palsy
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 2 , February 2012 , pp. 203 - 206
Copyright
Copyright © JLO (1984) Limited 2011

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