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Wegener's granulomatosis presenting as meningitis

Published online by Cambridge University Press:  14 September 2011

G Thiel ,
M Shakeel  and
K Ah-See
G Thiel*
Affiliation:
Department of Otorhinolaryngology, Aberdeen Royal Infirmary, Scotland, UK
M Shakeel
Affiliation:
Department of Otorhinolaryngology, Aberdeen Royal Infirmary, Scotland, UK
K Ah-See
Affiliation:
Department of Otorhinolaryngology, Aberdeen Royal Infirmary, Scotland, UK
*
Address for correspondence: Dr Gundula Thiel, University Department of Otorhinolaryngology, Lauriston Building, Lauriston Place, Edinburgh EH3 9HA, Scotland, UK E-mail: gundulathiel@doctors.org.uk
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Abstract

Background:

Wegener's granulomatosis is a rare but well recognised autoimmune necrotising vasculitis. Presentation of disease in the head and neck is common and mostly consists of nasal crusting, blockage and bloody discharge. Neurological presentation is very uncommon.

Methods:

We report a patient who presented to the medical emergency services with signs and symptoms of meningitis, but who was eventually diagnosed with Wegener's granulomatosis. A literature search on this topic was carried out using Medline and Embase (1996 to 2011), searching for ‘Wegener's granulomatosis’ and ‘meningitis’.

Results:

After thorough neurological and medical investigation, a combination of brain computed tomography, lumbar puncture, nasal biopsy and laboratory results refuted the diagnosis of meningitis and confirmed the diagnosis of Wegener's granulomatosis.

Conclusion:

To the best of our knowledge, this is the first English-language case report of a patient with Wegener's granulomatosis presenting with symptoms of meningitis unconfirmed on computed tomography and lumbar puncture.

Keywords

Wegener's GranulomatosisMeningitisNasal CavityDiagnosis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 2 , February 2012 , pp. 207 - 209
Copyright
Copyright © JLO (1984) Limited 2011

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