Wegener's granulomatosis is a severe form of systemic vasculitis (i.e. inflammation and necrosis of blood vessels involving many organs of the body). It occurs commonly in the fourth and fifth decade of life with upper respiratory tract complaints as the major presentation. Symptoms and signs are: cough, dyspnea, hemoptysis, sinusitis, otitis media, mastoiditis, stridor due to subglottic stenosis. Later, when the kidneys are involved, there is hematuria. The disease is rapidly fatal after the initial complaint.