Question

A 65-year-old female with type 2 diabetes and diabetic

peripheral neuropathy was hospitalized 1 week ago and
received piperacillin-tazobactam and gentamycin for
treatment of bibasilar pneumonia. At the time of hospital
discharge, she complained of dizziness and poor
balance during ambulation. She now reports that her
dizziness has worsened and she has been afraid to
walk. Her unsteadiness is worse if she attempts to ambulate
in the dark. She reports chronic bilateral hearing
loss mildly worse in her left ear, but denies tinnitus.
Orthostatic testing is unremarkable. Her neurologic examination
is remarkable only for a positive Romberg's
test and postural instability during ambulation. An
audiogram reveals moderately severe bilateral sensorineural
hearing loss (left mildly greater than right) with
gently sloping high-frequency hearing loss. What is the
most likely cause of her dizziness and poor balance?
a. Benign positional vertigo
b. Viral cochleitis
c. Bilateral vestibular dysfunction induced by gentamycin
d. Complication of diabetic peripheral neuropathy
e. Meniere's disease

Answer 1

The most likely cause of the patient's dizziness and poor balance is Meniere's disease.

Step-by-step explanation:

The most likely cause of the patient's dizziness and poor balance is Meniere's disease. Meniere's disease is a disorder that affects both equilibrium and audition and can present with symptoms such as vertigo, hearing loss, and tinnitus. The patient's symptoms, including worsening dizziness, poor balance in the dark, and bilateral sensorineural hearing loss, are consistent with Meniere's disease.