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Updated: May 22, 2025
Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss
Published on: January 25, 2016
Herpes simplex virus 2-induced aseptic meningitis presenting with sudden deafness: A case report
Yuan-Cheng Liu1, Shih-Hsuan Hsiao2, Peir-Rong Chen1
1Department of Otolaryngology, Hualien Tzu Chi Hospital, Hualien 970, Taiwan.
Background:
Aseptic meningitis is defined as meningeal inflammation caused by various etiologies with negative cerebrospinal fluid (CSF) bacterial culture. The most common etiologies are viruses [enteroviruses, arboviruses, and herpes simplex virus type 2 (HSV-2)]. Aseptic meningitis can have various presentations, including sensorineural deafness. While sensorineural deafness from mumps meningoencephalitis has been reported, cases of HSV-2-induced hearing loss are rare. Herein, we report a case of HSV-2-induced meningitis that presented with sudden deafness.
Case Summary:
A 68-year-old man experienced a profound sudden onset of left-sided hearing loss for one day. Pure-tone audiograms demonstrated sudden left-sided sensorineural hearing loss (thresholds 80-90 dB). After treatment with high-dose steroids for 1 week, he experienced an acute consciousness change with left hemiparesis. The laboratory data showed no significant abnormalities. Brain computed tomography without contrast and magnetic resonance imaging revealed no intracranial hemorrhage or obvious brain lesion. The CSF analysis and the Multiplex PCR panels showed HSV-2 positivity. Hence, under the diagnosis of herpes meningoencephalitis, acyclovir was prescribed and his symptoms gradually resolved.
Conclusion:
This case report further demonstrates that a viral infection could be a cause of sudden sensorineural hearing loss.
Insights
This case highlights herpes simplex virus type 2 (HSV-2) meningitis as a rare cause of sudden sensorineural hearing loss. Prompt diagnosis and treatment with acyclovir led to symptom resolution.
Area of Science:
- Neurology
- Infectious Diseases
- Otolaryngology
Background:
- Aseptic meningitis involves meningeal inflammation without bacterial culture positivity.
- Common viral causes include enteroviruses, arboviruses, and herpes simplex virus type 2 (HSV-2).
- Sensorineural deafness is a rare presentation of aseptic meningitis.
Observation:
- A 68-year-old man presented with sudden, profound left-sided hearing loss.
- Initial high-dose steroid treatment for hearing loss was followed by altered consciousness and hemiparesis.
- Cerebrospinal fluid analysis revealed HSV-2 positivity.
Findings:
- The patient was diagnosed with herpes meningoencephalitis.
- Treatment with acyclovir resulted in gradual symptom resolution.
- This case underscores the link between viral infections and sudden sensorineural hearing loss.
Implications:
- Highlights HSV-2 as a potential cause of sudden sensorineural hearing loss.
- Emphasizes the importance of considering viral meningoencephalitis in cases of unexplained hearing loss.
- Suggests timely antiviral therapy can improve outcomes in HSV-2-induced neurological complications.
