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[A case of pulmonary-limited Wegener granulomatosis mimicking bacterial pneumonia caused by Staphylococcus aureus].

Abstract
A 56-year-old woman who had suffered from systemic lupus erythematosus and Sjögren syndrome was admitted complaining of persistent cough. Chest X-ray films showed an infiltrative shadow in the right middle lung field. Her serum PR3-ANCA titer was high, and granulomatous inflammation with Langhans giant cell was noted in a transbronchial biopsy specimen. About 3 months later, purulent sputum and high grade fever developed, with a new infiltrative shadow in the left upper lung field noted on a chest X-ray film. We treated her based on a diagnosis of bacterial pneumonia caused by methicillin-resistant Staphylococcus aureus, but her condition did not improve. We finally gave her a diagnosis of pulmonary-limited Wegener's granulomatosis. Her condition improved with the administration of sulfamethoxazole-trimethoprim, prednisolone and cyclophosphamide. We report a case of pulmonary-limited Wegener granulomatosis which mimicked bacterial pneumonia caused by methicillin-resistant Staphylococcus aureus. This case suggests that Wegener's granulomatosis should be considered on encountering pneumonia caused by Staphylococcus aureus.
AuthorsMotoi Ugajin, Seiichi Miwa, Takafumi Suda, Masahiro Shirai, Hiroshi Hayakawa, Kingo Chida
JournalNihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society (Nihon Kokyuki Gakkai Zasshi) Vol. 49 Issue 4 Pg. 309-14 (Apr 2011) ISSN: 1343-3490 [Print] Japan
PMID21591462 (Publication Type: Case Reports, English Abstract, Journal Article)
Topics
  • Diagnosis, Differential
  • Female
  • Granulomatosis with Polyangiitis (diagnosis)
  • Humans
  • Middle Aged
  • Pneumonia, Bacterial (diagnosis)
  • Staphylococcal Infections (diagnosis)

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