Otosyphilis: A Rare Case of Unilateral Acute Sensorineural Hearing Loss

TL;DR

A rare case of otosyphilis causing sudden hearing loss in one ear is reported, emphasizing the need to consider syphilis in such diagnoses.

Contribution

This paper presents a novel clinical case linking otosyphilis to unilateral acute sensorineural hearing loss and highlights diagnostic considerations.

Findings

A 50-year-old female presented with left-sided hearing loss, tinnitus, headache, and nausea.

Positive syphilis serology and CSF analysis confirmed neurosyphilis as the cause of hearing loss.

Treatment with ampicillin and steroids improved symptoms but left residual hearing impairment at 1 kHz.

Abstract

Otosyphilis is a rare cause of acute sensorineural hearing loss. This report presents a case of otosyphilis causing unilateral acute sensorineural hearing loss in a 50-year-old female. The initial symptoms included left-sided hearing loss, tinnitus, headache, and nausea, which persisted despite oral steroid therapy. Blood tests revealed positive syphilis serology and cerebrospinal fluid (CSF) analysis indicated neurosyphilis. Treatment with ampicillin (AMPC) and tapered steroid therapy improved the symptoms, except for residual impairment at a frequency of 1 kHz. This case highlights the significance of considering syphilis in the differential diagnosis of acute sensorineural hearing loss, thorough history taking, serological testing, and when indicated, CSF analysis to ensure timely diagnosis and management.

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