Wegener's granulomatosis mimicking a parotid abscess.
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.
Jones
G L
GL
Department of Otorhinolaryngology, Royal Gwent Hospital, Newport, Wales. gljones@doctors.org.uk
Lukaris
A D
AD
Prabhu
H V
HV
Brown
M J K M
MJ
Bondeson
J
J
D000038:Abscess / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D003520:Cyclophosphamide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D014890:Granulomatosis with Polyangiitis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010305:Parotid Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D014456:Ulcer / Q000473:pathology
D019268:Antibodies, Antineutrophil Cytoplasmic; D003520:Cyclophosphamide