We present the case of a 61-year-old man who reported diplopia due to a right abducens nerve palsy. The patient complained of fever every night (37.5° C), paresthesia of the second and third hand fingers, and he showed an increased C-reactive protein, high erythrocyte sedimentation rate, and high eosinophilia. He had a history of allergic asthma, chronic rhinosinusitis, and surgically treated nasal polyps. His past medical history and labs led us to identify the eosinophilic granulomatosis with polyangiitis (EGPA), also known as Churg-Strauss syndrome. EGPA is a potentially life-threatening condition, and a proper diagnosis was critical to managing this patient's abducens nerve palsy.
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