Otosyphilis: A rare diagnosis in Otorhinolaryngology

Abstract

The incidence of acquired syphilis has increased during the last years. Otosyphilis can appear at any stage of the infection with Treponema pallidum. Hypoacusia, tinnitus, vertigo and disequilibrium are major symptoms. The diagnosis results from a combination of clinical manifestations with serologic evidence of syphilis and exclusion of other causes for neurosensorial hypoacusia. We present a clinical case of a 27 year-old male patient, with a 3 months longstanding bilateral and progressive hypoacusia and tinnitus and 3 days facial palsy. The etiological investigation confirmed the presence of syphilis (RPR = 64 dil. and TPHA = 1/1280) and exclusion of other causes; the diagnosis of otosyphilis and facial palsy was established. The patient was treated with intravenous penincilin G and prednisolone which resulted in remission of the symptoms. Syphilis continues to be a prevalent disease. When facing a patient with unexplained chocleovestibular manifestations otosyphilis should be consider as a possible diagnosis.