title: Wegener's granulomatosis mimicking skull base osteomyelitis.
abstract: OBJECTIVE
  To report a case of Wegener's granulomatosis mimicking skull base osteomyelitis.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Otorhinolaryngology and Head-Neck Services, Seth G S Medical College, King Edward VII Memorial Hospital, Mumbai, India. dr_arpit_sharma@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Sharma
authors.forename: S
authors.initials: S
authors.lastname: Deshmukh
authors.forename: A
authors.initials: A
authors.lastname: Shaikh
authors.forename: J
authors.initials: J
authors.lastname: Dabholkar
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic / Q000378:metabolism*; D001799:Blood Sedimentation; D003920:Diabetes Mellitus; D003937:Diagnosis, Differential; D005158:Facial Paralysis / Q000209:etiology*; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D034381:Hearing Loss / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D010032:Otitis Externa / Q000175:diagnosis*; D038781:Otoscopy; D014057:Tomography, X-Ray Computed
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic