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Published on: February 4, 2018
Spirochetes in otology: are we testing for the right pathogens?
Waleed M Abuzeid1, Michael J Ruckenstein
1Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
Summary
Otosyphilis was found in 4.9% of patients with idiopathic, progressive sensorineural hearing loss. Routine syphilis testing is recommended, but Lyme disease testing is not for this condition.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Neurology
Background:
- Idiopathic, progressive sensorineural hearing loss (SNHL) can have various causes.
- Otosyphilis and Lyme disease are potential, though often undiagnosed, contributors to SNHL.
Purpose of the Study:
- To determine the prevalence of otosyphilis and Lyme-associated labyrinthine disease in patients with idiopathic, progressive SNHL.
- To guide diagnostic workup recommendations for these conditions.
Main Methods:
- Prospective cohort study of 181 patients with idiopathic, progressive SNHL.
- Exclusion of cases with known causes of hearing loss.
- Comprehensive evaluation including history, physical exam, serology (syphilis, Lyme), audiometry, and MRI.
Main Results:
- Otosyphilis diagnosed in 9 cases (4.9%) via serological tests.
- No cases of Lyme disease were diagnosed.
Conclusions:
- Routine serological testing for otosyphilis is recommended for idiopathic, progressive SNHL.
- Routine serological testing for Lyme disease is not recommended for idiopathic, progressive SNHL.
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