Reversible hearing loss in temporal association with chemoprophylactic mefloquine use.
A 67 year old Caucasian lady received pre-travel immunizations against tetanus, diphtheria, typhoid fever, hepatitis A, and mefloquine chemoprophylaxis. Left sided hearing loss consequent upon tympanic rupture was present since childhood; she was otherwise in good health and without history of recent upper respiratory tract infection. After 1 dose of mefloquine right sided tinnitus and hearing loss developed; audiometry revealed mixed left sided loss and right sided sensorineural loss (-90db at 1kHz; -70dB at 4kHz). Prednisone, aspirin and omeprazole were prescribed; mefloquine chemoprophylaxis was discontinued. On day 9 of her hearing loss the tinnitus suddenly disappeared, and right sided hearing improved. Audiometry on day 93 revealed normal right sided hearing (-10dB at 1kHz; -10dB at 4kHz). Causality remains undetermined, but it may be prudent to avoid mefloquine chemoprophylaxis in individuals with known hearing impairment.
Wise
Mark
M
Burggartenstrassse 32, CH-4103 Bottmingen, Switzerland.
Toovey
Stephen
S
D000368:Aged; D019072:Antibiotic Prophylaxis; D000962:Antimalarials / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D003639:Hearing Loss, Sudden / Q000139:chemically induced*; D006801:Humans; D007114:Immunization; D008288:Malaria / Q000517:prevention & control; D015767:Mefloquine / Q000009:adverse effects* / Q000627:therapeutic use; D014012:Tinnitus / Q000139:chemically induced; D014195:Travel
D000962:Antimalarials; D015767:Mefloquine