title: Sudden-onset bilateral deafness revealing early neurosyphilis.
abstract: BACKGROUND
  Rapid-onset of sensorineural hearing loss in a patient at risk of genital or oral exposure to treponema can be secondary to early neurosyphilis, for which delayed treatment may result in irreversible sequelae.
  A 40-year-old, HIV seropositive man with a CD4 lymphocyte count greater than 500/mm(3) presented with rapid-onset of bilateral sensorineural hearing loss over a period of one week. Otorhinolaryngological examination was normal. The audiogram showed bilateral hearing loss of 25 and 30 decibels, respectively. He subsequently developed loss of visual acuity, leading to the diagnosis of syphilitic meningitis affecting the optic and auditory nerves.
  
  
  CONCLUSIONS
  In about one half of cases, neurosyphilis is an early manifestation of the disease occurring several weeks or months after contamination. Rapid- or even sudden-onset of hearing loss may be due to auditory neuritis. Clinical interview and syphilis serology in a patient at risk of exposure can allow rapid diagnosis and treatment, consisting of two weeks parenteral penicillin. Recovery of hearing loss is inconstant but can be complete.
authors.affiliation: Service de médecine interne, hôpital Louis-Mourier, centre hospitalier universitaire, (AP-HP), 178, rue des Renouillers, 92701 Colombes cedex, France.
authors.forename: A-L
authors.initials: AL
authors.lastname: Cassilde
authors.affiliation: Service de microbiologie, hôpital Louis-Mourier, centre hospitalier universitaire, (AP-HP), 178, rue des Renouillers, 92701 Colombes cedex, France.
authors.forename: G
authors.initials: G
authors.lastname: Barnaud
authors.affiliation: Service de radiologie, hôpital Louis-Mourier, centre hospitalier universitaire, (AP-HP), 178, rue des Renouillers, 92701 Colombes cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Baccar
authors.affiliation: Service de médecine interne, hôpital Louis-Mourier, centre hospitalier universitaire, (AP-HP), 178, rue des Renouillers, 92701 Colombes cedex, France. Electronic address: emmanuel.mortier@lmr.aphp.fr.
authors.forename: E
authors.initials: E
authors.lastname: Mortier
mesh_terms: D000328:Adult; D006679:HIV Seropositivity; D006312:Hearing Loss, Bilateral / Q000382:microbiology*; D003639:Hearing Loss, Sudden / Q000382:microbiology*; D006801:Humans; D008297:Male; D009494:Neurosyphilis / Q000175:diagnosis*