Granulomatosis with polyangiitis initially presenting as secretory otitis media: a case report.

Background: Granulomatosis with polyangiitis (GPA) is a rare systemic necrotizing vasculitis characterized by granulomatous inflammation of the upper and lower respiratory tracts, glomerulonephritis, and small vessel vasculitis. Otolaryngological manifestations are common in GPA and may precede systemic symptoms, often leading to delayed diagnosis. We report a case of GPA initially presenting as secretory otitis media, which was misdiagnosed and treated as infectious otitis media for a prolonged period. Case presentation: This study reports a case of atypical GPA in a 50-year-old woman. The patient presented with severe and complicated otitis media, accompanied by hearing loss and facial nerve palsy, as well as ear pain and high fever; however, she did not exhibit any other otolaryngological or systemic clinical manifestations associated with GPA. Conclusions: Diagnosing GPA is challenging due to its wide range of clinical manifestations. Otological signs and symptoms are relatively rare in this condition, though they may occasionally present as the initial manifestation. Early diagnosis and treatment are crucial for preventing serious and permanent complications caused by this disease. Early recognition and multidisciplinary collaboration are essential to prevent irreversible complications. Otolaryngologists should remain highly vigilant for systemic diseases such as GPA.