Difficulties in the Differential Diagnosis of Pneumonia Complicated by an Abscess and a Limited Variant of Wegener's Granulomatosis

Granulomatosis with polyangiitis (GPA) is a disease characterized by necrotizing granulomatous inflammation of small and medium vessels, mainly in the upper respiratory tract, lungs, and kidneys. Verifying the diagnosis can be difficult due to the variety of clinical presentations, possible multiple organ damage, and atypical course. GPA patients may have nonspecific symptoms characteristic of other bronchopulmonary diseases, which often leads to diagnostic errors. Methods. The article presents an analysis of literature data on the clinical and radiological aspects of lung damage during GPA and clinical observation of a 26-year-old patient who has been under regular follow-up at the TB department for infiltrative tuberculosis without bacterial excretion and received anti-tuberculosis therapy. At the end of the main course of treatment, the patient underwent surgery. Pulmonary tuberculosis was excluded based on histological and bacteriological examinations, but pneumonia with abscesses was diagnosed. Five years after the surgery, infiltrative changes in the operated right lung were detected again during the fluorography. These findings were regarded as tuberculosis. Tuberculosis treatment was carried out with a change in chemotherapy regimens due to the lack of radiological improvement. Results. The patient was referred to the Novosibirsk TB Research Institute. The institute specialists have expressed doubts about the tuberculous etiology because of the long pulmonary disease anamnesis, the previous X-ray findings, and pathological changes in the right lung. These doubts served as the basis to repeat the pathomorphological examination, which led to the diagnosis of granulomatosis with polyangiitis. Conclusion. According to the presented clinical observation, the difficulties of timely verification of the diagnosis have been demonstrated, which is associated with the lack of vigilance among doctors regarding GPA.

show abstract

Granulomatosis with polyangiitis (Wegener’s): a clinical case of overdiagnosis of pulmonary tuberculosis

Лаушкина

Pushkareva

Medvedev

et al. 2022

Pulʹmonologiâ (Mosk.)

View full text Add to dashboard Cite

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Difficulties in the Differential Diagnosis of Pneumonia Complicated by an Abscess and a Limited Variant of Wegener's Granulomatosis

Cited by 1 publication

References 6 publications

Granulomatosis with polyangiitis (Wegener’s): a clinical case of overdiagnosis of pulmonary tuberculosis

Granulomatosis with polyangiitis (Wegener’s): a clinical case of overdiagnosis of pulmonary tuberculosis

Contact Info

Product

Resources

About