A 64-year-old woman living in the western Chinese city of Nanchong was hospitalized, because of dizziness and fatigue for 2 mo and hearing loss for the last 15 d. About two months before admission, she developed dizziness and fatigue which was relieved after rest. There was no headache, nausea, vomiting, ataxia, nystagmus, palpitation, or other discomfort. Approximately 15 d before admission, her symptoms aggravated, accompanied by slight headache, and bilateral intermittent tinnitus with high frequency tone. Tinnitus did not interfere with sleep. She also developed bilateral progressive hearing loss, but there was no vertigo. There was no clear history of fever before admission. She was admitted to the Department of Hematology at our hospital. She had no history of chronic diseases or infectious diseases. She had no family history of genetically related diseases. At admission, her vital parameters were: Temperature 36.5°C; pulse rate 98 per minute; respiration rate 20 per minute; blood pressure 116/68 mmHg. She appeared cachectic and pale. She had splenomegaly, but there was no hepatomegaly or mucosal petechiae. No abnormalities were detected on cardiopulmonary. On neurological examination, she was conscious, cooperative, and well-oriented with normal mental faculties. Her limb muscle strength and muscle tension were normal. There was no neck stiffness, Kerning sign and Brudzinski sign were negative. There was no papilledema. On ear examination, the bilateral auriculae were normal, the external ear canal was unobstructed, the tympanic membrane was intact, and the Politzcr cone was normal. She developed fever on the night of admission. Double sets of blood culture were obtained during the fever episode. Blood counts showed pancytopenia (platelets: 95 × 109/L; hemoglobin 5.6 g/dL; white blood cell (WBC) count 2.97 × 109/L). Her biochemical parameters were: Aspartate aminotransferase 83 U/L; lactate dehydrogenase 503 U/L; alanine aminotransferase 42 U/L; C-reactive protein 26.38 mg/L; procalcitonin 0.172 ng/mL. Coomb's test was negative. Routine urine and fecal examination showed no signs of infection. She tested negative for antibodies against Hepatitis B, C, and human immunodeficiency virus. Bone marrow smear showed a reactionary marrow. Lumbar puncture revealed colorless and clear cerebrospinal fluid (CSF); the CSF pressure was 101 mmH2O, white blood cell count was 7 × 106/L; there were no leaf cells or lymphocytes; other CSF parameters were: microalbumin 0.373 g/L, lactate dehydrogenase 29.3 U/L, glucose 3.33 mmol/L, chlorine 125.4 mmol/L. Gram-stain negative, ink-stain negative, acid-fast bacilli negative. CSF cultures were negative. Head computed tomography showed possible bilateral paraventricular lacunar infarction and intracranial arteriosclerosis. Abdominal ultrasound showed splenomegaly. Echocardiography showed mild mitral and tricuspid regurgitation.