Korean J Med.  2009 Apr;76(Suppl 1):S97-S102.

A case of Wegener's granulomatosis masquerading as a lung abscess

• Kim HO
• Jung KH
• Kim JH
• Park HJ
• Kim YS
• Shin C

Abstract

Wegener's granulomatosis is a small vessel vasculitis characterized by necrotizing granulomatous inflammation of the upper and lower respiratory tracts and kidney. Early diagnosis and immediate treatment are very important for a better prognosis, but the nonspecific, variable clinical manifestations and radiologic findings make the diagnosis difficult. A positive proteinase 3-antineutrophil cytoplasmic antibody test is helpful for the diagnosis of Wegener's granulomatosis. Here, we report a case of Wegener's granulomatosis in 54-year-old man who initially presented with fever and multiple cavitary consolidations on the chest radiograph suggestive of a lung abscess. The final diagnosis of Wegener's granulomatosis was based on the medical history of otitis media, gradually developed microscopic hematuria, necrotizing granulomatous inflammation on lung histopathology, and a positive proteinase 3-antineutrophil cytoplasmic antibody test.

Keyword

Wegener's granulomatosis; Interstitial lung disease; Antineutrophil cytoplasmic antibody

MeSH Terms

Antibodies, Antineutrophil Cytoplasmic
Cytoplasm
Early Diagnosis
Fever
Glycosaminoglycans
Hematuria
Humans
Inflammation
Kidney
Lung
Lung Abscess
Lung Diseases, Interstitial
Middle Aged
Otitis Media
Prognosis
Respiratory System
Thorax
Vasculitis
Wegener Granulomatosis
Antibodies, Antineutrophil Cytoplasmic
Glycosaminoglycans