An Unusual Case of Otitis Media

This case report of bilateral otitis media in a 39-year-old woman secondary to Wegener's Granulomatosis highlights, for the audiologist, the importance of being aware of some of the less common etiologies of middle ear disease. Bilateral otitis media that resists usual forms of medical treatment may represent one of the earliest signs of Wegener's Granulomatosis, a potentially life-threatening disease. According to recent literature, involvement of the ears, nose, and throat can in many instances be the only early manifestation of the disease. It is important that audiologists be aware of the early signs in order to make appropriate referral for treatment, particularly since they are usually among the first to see these patients. Early diagnosis and referral is critical since the mean survival of untreated WG is five months, with 82% of patients dying within one year, and more than 90% dying within two years. The disease involves a systemic vasculitis that may involve any organ system: however, pulmonary or renal disease appear to be among the later signs, while both middle ear and upper respiratory involvement are frequently among the earliest.

Key Words

Autoimmune disease - cytoxan - methotrexate - otitis media - prednisone - systemic vasculitis - Wegener's granulomatosis