WEGENERS GRANULOMA - PRESENTING AS A UNILATERAL PAROTID SWELLING

Wegener's granuloma is a systemic necrotizing vasculitis which predomi nantly affects the upper and lower respiratory tracts and kidneys. The nose and paranasal sinuses are often the first or main sites to be af fected. Equally ear involvement is common and a recognized early manif estation of the disease. Salivary gland involvement is rare and is usu ally part of more widespread systemic involvement. We present a 34-yea r-old female with a six-week history of hearing loss and a unilateral parotid swelling. One year previously she was diagnosed as having myal gic encephalomyelitis following a long period of post-viral malaise. T he case points to the difficulties encountered when Wegener's granulom a presents in an unusual and varied way. A high index of suspicion cou pled with early diagnosis and treatment is essential. The patient made a good recovery.