Infection screening in sudden and progressive idiopathic sensorineural hearing loss: a retrospective study of 182 cases.
OBJECTIVE
To evaluate a systematic infectious screening program for patients who present with sudden or progressive sensorineural hearing loss (SHL) of unknown cause (negative history and clinical examination).


METHODS
Retrospective study of 182 patients with idiopathic SHL. One hundred six patients presented with sudden SHL, and 76 presented with progressive SHL. Serologies for herpes simplex and varicella-zoster viruses (immunoglobulin M and immunoglobulin G titers), Lyme disease (enzyme-linked immunosorbent assay), syphilis (fluorescent treponemal antibody absorption or microhemagglutination-Treponema pallidum test) and human immunodeficiency virus were performed.


RESULTS
The serologies were negative in 179 patients. Two patients had positive serologies for Lyme disease and another tested positive for syphilis. Both cases of suspected Lyme disease were later excluded by Western blot analysis and lumbar puncture (two false-positives). The patient with serologic syphilis was diagnosed as having latent syphilis after neurosyphilis was excluded.


CONCLUSIONS
The infection screening was positive in only 1 (0.6%) of 182 patients: the patient who was diagnosed with latent syphilis. On the basis of these results and taking into account the cost of systematic screening, we propose that serologic tests be limited to patients with suspect histories or symptomatologies, except for patients with a diagnosis of syphilis.
Gagnebin
Joël
J
Clinic of Otolaryngology-Head and Neck Surgery, University Hospital, Lausanne, Switzerland. Joel.Gagnebin@chuv.hospvd.ch
Maire
Raphaël
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000276:immunology; D015153:Blotting, Western; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000453:epidemiology* / Q000276:immunology / Q000821:virology*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012189:Retrospective Studies; D014777:Virus Diseases / Q000453:epidemiology* / Q000276:immunology / Q000821:virology*
D000914:Antibodies, Viral