Fever of unknown origin, bilateral sensorineural hearing loss with canal paresis and uveitis with iridocyclitis and episcleritis: a case of Cogans syndrome

Description

A 69-year-old Japanese woman presented with 1-month history of continuous spiking fever, proximal myalgia with weakness, weight loss, intermittent abdominal pain and lower back pain. Except for the use of oral hypoglycaemic drugs to control her diabetes mellitus over the last 7 years, she had been otherwise healthy until she developed these symptoms. Additionally, she had a history of recurrent tinnitus and vertigo for the last 2 years and was suspected to have Ménière's disease or benign paroxysmal positional vertigo by an otolaryngologist. Seven days prior to her first visit, she developed progressively worsening bilateral deafness. She was admitted to the surgical ward to assess intermittent abdominal pain and subsequently underwent gynaecological examination; however, no diagnosis was made. Five days after the admission, she developed progressive bilateral blurred visions and an ophthalmologist diagnosed her with uveitis with iridocyclitis and episcleritis (figure 1A). She was then referred to...

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