Granulomatosis with polyangiitis - An oral medicine case book

A 33-year-old female patient presented at a private specialist practice (Periodontics and Oral Medicine) with a main complaint of sore and bleeding gums, fever, headaches and sinus pain. The gingiva became irritated, red and swollen five weeks prior to the first consultation in July 2018.\r\nShe was referred by her dentist one month after prescribing two consecutive courses of antibiotics and providing oral hygiene instructions to the patient, with no significant improvement. The first prescription was for Augmentin 375mg t.d.s. for 5 days and the second prescription two weeks later was for Amoxycillin 250 mg t.d.s. and Metronidazole 200mg t.d.s. for 5 days. The patient was also using a chlorhexidine mouth rinse.