Wegener's granulomatosis triggered by infection?

Acta Otorhinolaryngol Belg. 2001;55(1):57-63.


Wegener's granulomatosis is a systemic disease of unknown origin, although recent studies suggest that auto-immune mechanisms and infection play a role in the pathogenesis of this disease. Wegener is characterized by a necrotizing vasculitis involving the lungs (pulmonary infiltrates), the upper airways and the kidneys (rapidly progressive glomerulonephritis). We present a case of a male patient admitted because of progressive deterioration of the general condition with weight loss, a unilateral neck mass, unilateral purulent rhinorrea and fever. CT-scan evaluation demonstrated a unilateral expanding mass in the sing-nasal cavity, obliterating the ethmoid complex. MRI revealed signs of intracranial inflammatory reaction and onset of absedation. A malignancy was suspected but a diagnosis of Wegener's granulomatosis was established based on histologic criteria (nasal biopsy) and a positive titer for anti-cytoplasmic antibodies (cANCA). During follow-up, nasal carriage of Staphyloccocus Aureus could be documented. An overview of Wegener's granulomatosis will be provided with emphasis on the potential role of acute infections as a trigger for Wegener's granulomatosis and the head and neck manifestations.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Antibodies, Antineutrophil Cytoplasmic / blood
  • Biopsy
  • Carrier State* / diagnosis
  • Fatigue / microbiology
  • Fever / microbiology
  • Granulomatosis with Polyangiitis / blood
  • Granulomatosis with Polyangiitis / diagnosis*
  • Granulomatosis with Polyangiitis / immunology
  • Granulomatosis with Polyangiitis / microbiology*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Nasal Mucosa / microbiology*
  • Rhinitis / microbiology
  • Sinusitis / microbiology
  • Staphylococcal Infections / complications*
  • Staphylococcal Infections / diagnosis
  • Suppuration
  • Tomography, X-Ray Computed
  • Weight Loss


  • Antibodies, Antineutrophil Cytoplasmic