Abstract:
Otosyphilis is a rare cause of audiovestibular dysfunction that can easily be misdiagnosed. Here, we report a rare case in which a patient presented with secondary benign paroxysmal positional vertigo (BPPV) 2 weeks after symptoms of otosyphilis appeared. The Dix-Hallpike test showed a classical response in the head-hanging left position. The patient was treated with intravenous penicillin G and the canalith repositioning maneuver, which completely resolved the vertigo. The patient\'s audiovestibular symptoms resolved gradually. The elevated cerebrospinal fluid (CSF) white blood cell (WBC) count returned to normal and the results of the Treponema pallidum particle agglutination (TPPA) test were negative at the 3-month follow-up. This report suggests that otosyphilis should be considered in the differential diagnosis of audiovestibular dysfunction in patients at risk. Additionally, clinicians should remain vigilant about the possibility of secondary BPPV in patients with otosyphilis who report positional vertigo.
摘要:
耳梅毒是听力前庭功能障碍的罕见原因,很容易误诊。这里,我们报道了一例罕见病例,其中1例患者在耳梅毒症状出现2周后出现继发性良性阵发性位置性眩晕(BPPV).Dix-Hallpike测试表明,在悬头的左侧位置具有经典反应。患者接受了静脉注射青霉素G和耳石重新定位的治疗,彻底解决了眩晕。患者的听前庭症状逐渐缓解。脑脊液(CSF)白细胞(WBC)计数升高,3个月随访时梅毒螺旋体颗粒凝集(TPPA)试验结果为阴性。该报告表明,在有风险的患者的听觉前庭功能障碍的鉴别诊断中应考虑耳梅毒。此外,临床医师应对报告位置性眩晕的耳梅毒患者继发BPPV的可能性保持警惕.