title: Wegener's Granulomatosis presenting with an abscess in the parotid gland: a case report.
abstract: BACKGROUND
  Wegener's Granulomatosis is a vasculitis of uncertain aetiology. Affected patients usually present with disease of the respiratory and renal tracts. Classic symptoms and clinical findings, together with serology titres positive for anti-neutrophil cytolplasmic antibody against proteinase 3 confirm the diagnosis. Wegener's Granulomatosis can occasionally involve other organs, but solitary parotid gland disease is uncommon; patients generally also have systemic disease.
  
  
  METHODS
  We report a case of Wegener's Granulomatosis in a 69-year-old Caucasian female presenting initially with an isolated parotid abscess and only subsequently developing nasal, paranasal sinus and respiratory symptoms. We describe the clinical course, diagnostic difficulties, imaging and histopathology of this case.
  
  
  CONCLUSIONS
  Major salivary gland infection is not an uncommon ENT disorder, but the clinician should be wary of the patient who fails to respond appropriately to adequate therapy. In such cases a differential diagnosis of Wegener's Granulomatosis should be considered, as early recognition and treatment of this potentially fatal disease is paramount.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth, Hampshire, UK. marcel_geyer@dsl.pipex.com.
authors.forename: Marcel
authors.initials: M
authors.lastname: Geyer
authors.forename: Gautham
authors.initials: G
authors.lastname: Kulamarva
authors.forename: Anne
authors.initials: A
authors.lastname: Davis