Aortitis Secondary to Cogan’s Syndrome: A Rare Cause of Fever of Unknown Origin

Maria Margarida Rosado; Cláudia Queirós; Vanda Conceição; Nuno Bernardino Vieira; Luísa Arez

doi:10.12890/2022_003585

Maria Margarida Rosado
Serviço de Medicina 3, Centro Hospitalar Universitário do Algarve - Unidade Hospitalar de Portimão, Portimão, Portugal https://orcid.org/0000-0002-3986-2287
Cláudia Queirós
Serviço de Medicina 3, Centro Hospitalar Universitário do Algarve - Unidade Hospitalar de Portimão, Portimão, Portugal https://orcid.org/0000-0003-2247-5915
Vanda Conceição
Serviço de Medicina 3, Centro Hospitalar Universitário do Algarve - Unidade Hospitalar de Portimão, Portimão, Portugal https://orcid.org/0000-0002-7407-6871
Nuno Bernardino Vieira
Serviço de Medicina 3, Centro Hospitalar Universitário do Algarve - Unidade Hospitalar de Portimão, Portimão, Portugal https://orcid.org/0000-0001-8168-8115
Luísa Arez
Serviço de Medicina 3, Centro Hospitalar Universitário do Algarve - Unidade Hospitalar de Portimão, Portimão, Portugal https://orcid.org/0000-0003-2783-3523

Keywords

Aortitis, Cogan’s syndrome, fever of unknown origin

Abstract

Fever of unknown origin remains a diagnostic challenge. Aortitis, defined as inflammation of the aorta, has multiple infectious and non-infectious causes.<br/>
We report the case of an elderly woman with vertigo and bilateral hearing loss, presenting with fever of unknown origin. Blood tests were remarkable for leucocytosis with neutrophilia, elevation of C-reactive protein and the erythrocyte sedimentation rate, and positive antinuclear antibodies and rheumatoid factor, and an unremarkable search for multiple infectious causes of fever. During admission the patient developed a bilateral red eye. Abdominal and chest computed tomography was performed and demonstrated signs of aortitis.
Due to the coexistence of aortitis, ocular inflammation, vertigo and bilateral hearing loss in a patient with persistent fever and elevation of inflammatory parameters, a presumptive diagnosis of Cogan’s syndrome was made, with improvement after initiation of steroid therapy.

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Published: 2022-10-05
Issue: 2022: Vol 9 No 10 (view)

How to cite:

1.

Rosado MM, Queirós C, Conceição V, Vieira NB, Arez L. Aortitis Secondary to Cogan’s Syndrome: A Rare Cause of Fever of Unknown Origin. EJCRIM 2022;9 doi:10.12890/2022_003585.