Otosyphilis and HIV: Therapeutic Dilemma and Outcome of Treatment

Overview

Journal BMJ Case Rep

Specialty General Medicine

Date 2011 Oct 15

PMID 21998618

Citations 5

Authors

Bruce John McKenzie

J W Loock

Affiliations

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Abstract

We present a case report and review the world literature concerning otosyphilis, particularly with reference to the HIV positive patient. Our patient received two separate courses of treatment for otosyphilis. A course of intramuscular penicillin and oral prednisone resulted in no improvement in his hearing thresholds. A subsequent course of intravenous penicillin and oral prednisone resulted in an improvement of 79 db in his three frequency pure tone average. Otosyphilis is one of the rare causes of treatable sensorineural hearing loss. HIV has been shown to increase the severity and the progression of luetic ear disease. This case reveals that the optimal treatment remains a 10 day course of intravenous penicillin and oral prednisone.

Citing Articles

Otosyphilis: A Rare Cause of Reversible Hearing Loss in a Teenage Male.

He S, Messner A, Mirani G Cureus. 2022; 14(3):e23468.

PMID: 35494944 PMC: 9038597. DOI: 10.7759/cureus.23468.

Otosyphilis: A rare cause of acute bilateral sensorineural hearing loss in a HIV-negative patient.

Sothmann J, Adam S, van Tonder G, Davis R, van Rensburg L SA J Radiol. 2022; 26(1):2351.

PMID: 35402007 PMC: 8991266. DOI: 10.4102/sajr.v26i1.2351.

Otosyphilis with Clinical and Serologic Responses with Weekly Intramuscular Penicillin: A Case Report and Literature Review.

Etemady-Deylamy A, Abate G Case Rep Infect Dis. 2022; 2022:3152383.

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Neurosyphilis presenting as cranial nerve palsy, an entity which is easy to miss.

Piura Y, Mina Y, Aizenstein O, Gadoth A BMJ Case Rep. 2019; 12(2).

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Newly diagnosed AIDS with neurosyphilis, Kaposi sarcoma, pancytopenia, oropharyngeal candidiasis, and pseudomonal pneumonia: We shouldn't be seeing this anymore.

Yunina D, Elkayam N, Patel S, Okoli F, Chapnick E, Hecht M IDCases. 2018; 13:e00426.

PMID: 30101071 PMC: 6076223. DOI: 10.1016/j.idcr.2018.e00426.

References

Gleich L, Linstrom C, Kimmelman C . Otosyphilis: a diagnostic and therapeutic dilemma. Laryngoscope. 1992; 102(11):1255-9. DOI: 10.1288/00005537-199211000-00010. View

Mishra S, Walmsley S, Loutfy M, Kaul R, Logue K, Gold W . Otosyphilis in HIV-coinfected individuals: a case series from Toronto, Canada. AIDS Patient Care STDS. 2008; 22(3):213-9. DOI: 10.1089/apc.2007.0019. View

Klemm E, Wollina U . Otosyphilis: report on six cases. J Eur Acad Dermatol Venereol. 2004; 18(4):429-34. DOI: 10.1111/j.1468-3083.2004.00939.x. View

Pialoux G, Vimont S, Moulignier A, Buteux M, Abraham B, Bonnard P . Effect of HIV infection on the course of syphilis. AIDS Rev. 2008; 10(2):85-92. View

Zoller M, Wilson W, Nadol Jr J . Treatment of syphilitic hearing loss. Combined penicillin and steroid therapy in 29 patients. Ann Otol Rhinol Laryngol. 1979; 88(2 Pt 1):160-5. DOI: 10.1177/000348947908800202. View