Wegener's granulomatosis presenting as multiple Staphylococcal lung abscesses

We present here the case of a young lady with Wegener's granulomatosis (WG), a rare disease in clinical practice, who presented with multiple large lung abscesses secondary to disseminated Staphylococcal infection. This lady presented with fever, toothache, earache, hearing loss and symptoms of a lower respiratory tract infection. Radiology showed multiple lung abscesses. Fever reduced, but did not remit, with antibiotic treatment. The sinus, dental and systemic symptoms also persisted until the commencement of steroids and cyclophosphamide treatment, following confirmation of WG by a positive C-ANCA/ELISA proteinase 3. The radiology also normalized following this treatment. This case suggests the possibility that disseminated Staphylococcus infection or Staphylococcus pneumonia could precipitate the initial presentation of WG.