[Infectious aspects of Wegener's granulomatosis].

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.