Sudden deafness as an initial presentation of varicella: case report and literature review

Varicella, or chickenpox, is a highly contagious disease transmitted by the varicella zoster virus (VZV). Idiopathic sudden sensorineural hearing loss (ISSNHL) has been defined as a loss of at least 30 dB over at least three frequencies on audiogram within three days and with an uncertain cause. Deafness caused by varicella-zoster virus occasionally occurred in Ramsey hunter syndrome but associated with chickenpox is rare. We present a case of an adult varicella infection with sudden deafness as the first symptom. The patient begins with a sudden hearing loss in his left ear and developed fever 12 days later and skin rash 13 days later. He was diagnosed as chickenpox and received treatment of oral famciclovir capsule 250 mg administrated three times daily. After 2 weeks, at an outpatient follow-up the patient reported that while his scabs had fallen off and he felt well, the sudden deafness in the left ear had not improved. This kind of cases are rare and suggest the relationship between VZV and sudden deafness. Sudden deafness can be the first symptom of chickenpox. In this study, we also reviewed pathogenesis, clinical feature and the epidemiological character of chickenpox, the neurological complications of varicella zoster and the etiology of sudden deafness.