A very unusual case history

The above case history demonstrates well how a severe potentially lethal medical condition can often develop quite insidiously with what appeared to be quite common and everyday symptoms initially. In my opinion, one of the potential problems with the management of this lady was the number of different doctors she consulted within the practice, both military and locum (11 in total during 2007) resulting in lack of continuity of case. However, it is impossible to ascertain quite when the vasculitis actually developed or whether it could have been suspected earlier. In nearly 30 years as a doctor, this is the first case of Wegener's that I have knowingly come across. Perhaps because of such rarities, this is what makes being a GP such an interesting and challenging role. So next time you see someone with a runny nose and dry cough .... think again!