Spirochetes in otology: are we testing for the right pathogens?
OBJECTIVE
To determine the prevalence rate of otosyphilis and Lyme-associated labyrinthine disease among patients presenting with idiopathic, progressive sensorineural hearing loss and, thus, to provide recommendations regarding the diagnostic workup.


METHODS
A prospective cohort study of patients presenting to a university hospital otology clinic with idiopathic, progressive sensorineural hearing loss between 1998 and 2006.


METHODS
Cases in which hearing loss was clearly attributable to other causes were excluded, leaving 181 patients (mean age 55.6 years). History, physical examination, autoimmune laboratory tests, syphilis and Lyme serology, audiometric assessment, and MRI were performed in all cases.


RESULTS
Nine cases (4.9%) of otosyphilis and none of Lyme disease were diagnosed by serological tests.


CONCLUSIONS
Routine serological testing for otosyphilis, but not Lyme disease, is recommended for all cases of idiopathic, progressive sensorineural hearing loss.
Abuzeid
Waleed M
WM
Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
Ruckenstein
Michael J
MJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000032:analysis; D015153:Blotting, Western; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology; D010414:Pennsylvania / Q000453:epidemiology; D011446:Prospective Studies; D013144:Spirochaetales / Q000276:immunology / Q000302:isolation & purification*; D013145:Spirochaetales Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*
D000907:Antibodies, Bacterial