Wegener's granulomatosis: challenges in making the diagnosis- a case report

Wegener's granulomatosis is a rare multi systemic illness with unclear aetiology. It can present with various signs and symptoms with involvement of multiple organ systems. Here, we present a case of a 45-year-old male who presented with multiple episodes of epistaxis. Upon subsequent follow up, he also developed right facial nerve palsy and bilateral mixed hearing loss. Subsequently, there was incidental findings of opacities on chest radiograph, which did not resolve with antibiotics treatment. Computed tomography thorax was performed, which revealed features suggestive of lung malignancy. Lung biopsy finally revealed a diagnosis of Wegener's granulomatosis (WG). This case is particularly interesting due to the diverse presenting symptoms, radiological findings mimicking other pathology and lastly the diagnosis of WG upon histopathology result.