Cryptococcal meningitis: presentation as sudden deafness.
A patient presented with a bilateral profound hearing loss of sudden onset following a two-month neurologic illness. Microscopy and culture of cerebrospinal fluid revealed Cryptococcus neoformans. Treatment with amphotericin B and 5-fluorocytosine failed to restore hearing. Auditory brain stem response and electrical promontory stimulation suggest a profound deafness with poor neuronal survival. This is consistent with previous temporal bone histopathology reports in individuals dying of cryptococcal meningitis, suggesting a retrocochlear lesion. It is important to exclude this occult pathologic factor in a patient with the sudden onset of sensorineural deafness prior to embarking upon a course of steroid therapy.
D000666:Amphotericin B / Q000627:therapeutic use; D001300:Audiometry, Evoked Response; D003453:Cryptococcosis / Q000150:complications* / Q000188:drug therapy; D004584:Electronystagmography; D005072:Evoked Potentials, Auditory; D005260:Female; D005437:Flucytosine / Q000627:therapeutic use; D003639:Hearing Loss, Sudden / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008581:Meningitis / Q000150:complications* / Q000188:drug therapy; D008875:Middle Aged
D000666:Amphotericin B; D005437:Flucytosine