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Video

Pediatric Otolaryngology

(A908) ANCA-Associated Vasculitides(AAV) Presenting as Isolated Right Infra-auricular Abscess

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • CL

    Chih-Hsien Liu, MD

    Attending Physician
    Department of Otolaryngology Head and Neck Surgery, Cathay General Hospital, Taipei, Taiwan
    Taipei, Taipei, Taiwan (Republic of China)

    • Senior Author(s)

  • TF

    Te-Yung Fang, MD

    Attending Physician
    Cathay General Hospital, Taipei, Taiwan
    Taipei, Taipei, Taiwan (Republic of China)

    • Co-Author(s)

  • HL

    Hsiao-Shuang Lin, MD

    Resident of Postgraduate Year 2
    Cathay General Hospital, Taipei, Taiwan
    Taipei, Taipei, Taiwan (Republic of China)

Disclosure(s):
Chih-Hsien Liu, MD: No relevant relationships to disclose.
Te-Yung Fang, MD: No relevant relationships to disclose.
Hsiao-Shuang Lin, MD: No relevant relationships to disclose.


Introduction: Anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitides (AAV) are classified into three distinct diseases based on clinical and pathological features: granulomatosis with polyangiitis (GPA, formerly Wegener’s granulomatosis), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA, Churg–Strauss syndrome).

Methods: A 10-year-old Asian boy had no congenital disorder. He had right infra- auricular tumor and received right parotid operation at other medical center in 2021/03. The pathology report revealed granulomatous inflammation and salivary gland tissue with abscess formation. One lobulated/cystic lesion along previous scar was noted by his family in 2022/07, so we arranged the head and neck computed tomography (CT) with contrast revealed heterogeneous enlargement of right parotid gland with two air bubbles and internal necrosis. We arranged right neck abscess incision and drainage and the pathology still revealed necrotizing granulomatous inflammation. We also sent the abscess for bacterial and tuberculosis culture and only some Coagulase-negative Staphylococcus was found but no Mycobacterium was isolated. The blood test of the patient showed c-ANCA positive and Anti-proteinase 3 (PR3) Ab=3.7 IU/ml , but Anti-myeloperoxidase (MPO) Ab was negative. Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides was diagnosed and the patient was treated with oral prednisolone and the pediatrician treated secondary bacterial infection with Co-trimoxazole.

Results: After taking Co-trimoxazole for three months and low dose prednisolone for one month, the patient received sonography for head and neck region and showed no evidence of recurrence nor subcutaneous granulation.

Conclusions: When we treat a pediatric patient with neck mass and abscess formation but refractory to medical or surgical management, referral to a pediatrician may be indicated and some rare auto-immune disorders such as vasculitis should be considered for differential diagnosis.