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[Infectious aspects of Wegener's granulomatosis]
1Klinik für Hals-, Nasen- und Ohrenkrankheiten, Hals- und Gesichtschirurgie, Kantonsspital Luzern.
Introduction:
Because of manifestation of Wegener's granulomatosis in the upper respiratory tract the ENT-specialist is often initially involved in diagnosis. Recent research results suppose the chronic nasal carriage of Staphylococcus aureus triggering relapse rate in Wegener's granulomatosis. The adequate therapy of this bacteria as chronic nasal carriage may reduce the number of relapses in patients with Wegener's granulomatosis in remission.
Patient:
An illustrative case report shows the positive effect of prolonged treatment with cotrimoxazole in a 49-year-old male with a second relapse of Wegener's granulomatosis.
Results:
The prolonged treatment of cotrimoxazole reduced the dose of cyclophosphamid and glucocorticoids which show long-term side effects.
Discussion:
15 years ago a positive effect of cotrimoxazole to Wegener's granulomatosis was discussed. Later immunological and clinical studies confirmed this fact. Prolonged treatment with cotrimoxazole seems to reduce the number of relapses in patients with this chronic disease. Corresponding with our case reduction of the systemic therapy with cyclophosphamid and glucocorticoids is possible.
Insights
Treating chronic nasal Staphylococcus aureus carriage with cotrimoxazole may reduce Wegener
Area of Science:
- Rheumatology and Otolaryngology
- Infectious Disease Epidemiology
Background:
- Wegener's granulomatosis (WG) frequently presents in the upper respiratory tract, involving ENT specialists in early diagnosis.
- Chronic nasal carriage of Staphylococcus aureus is hypothesized to trigger relapses in WG patients.
- Targeting S. aureus nasal carriage may reduce WG relapse rates in patients in remission.
Observation:
- A case report details a 49-year-old male experiencing his second WG relapse.
- This patient underwent prolonged treatment with cotrimoxazole.
Findings:
- Prolonged cotrimoxazole therapy demonstrated a positive effect in the WG patient.
- Treatment allowed for a reduction in the dosage of cyclophosphamide and glucocorticoids.
- This reduction mitigates potential long-term side effects associated with systemic immunosuppressants.
Implications:
- Long-term cotrimoxazole treatment may decrease relapse frequency in chronic WG.
- This approach could enable reduced reliance on high-dose immunosuppressive therapies.
- Further research into S. aureus eradication strategies for WG management is warranted.