title: Lyme disease: sudden hearing loss as the sole presentation.
abstract: BACKGROUND
  Lyme disease is an uncommon tick-borne multisystemic infection caused by Borrelia burgdorferi. The most common clinical manifestation is erythema migrans. In this report, a very unusual presentation of this condition is described, in which sudden onset sensorineural hearing loss was the sole presenting symptom.
  
  
  METHODS
  Case report and review of English-language literature.
  
  
  RESULTS
  A patient presented with sensorineural hearing loss, with no other symptoms or signs. Acute Lyme infection was detected by laboratory tests. Magnetic resonance imaging showed signs of labyrinthitis of the same inner ear. After hyperbaric oxygen and systemic antibiotic treatment, the patient showed total hearing recovery, and magnetic resonance imaging showed complete resolution of the labyrinthitis.
  
  
  CONCLUSIONS
  To our knowledge, this is the first reported case of Lyme disease presenting only with sensorineural hearing loss. Borreliosis should be considered as an aetiological factor in sensorineural hearing loss. Adequate treatment may provide total recovery and prevent more severe forms of Lyme disease.
authors.affiliation: ENT Department,CUF Descobertas Hospital,Lisbon,Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Espiney Amaro
authors.affiliation: ENT Department,CUF Descobertas Hospital,Lisbon,Portugal.
authors.forename: P
authors.initials: P
authors.lastname: Montalvão
authors.affiliation: ENT Department,Barts Royal London Hospitals,UK.
authors.forename: C
authors.initials: C
authors.lastname: Huins
authors.affiliation: ENT Department,CUF Descobertas Hospital,Lisbon,Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Saraiva
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D025065:Borrelia burgdorferi / Q000302:isolation & purification; D005260:Female; D003639:Hearing Loss, Sudden / Q000097:blood / Q000382:microbiology*; D006801:Humans; D006931:Hyperbaric Oxygenation; D007762:Labyrinthitis / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D008193:Lyme Disease / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D014012:Tinnitus / Q000382:microbiology / Q000473:pathology; D014717:Vertigo / Q000382:microbiology / Q000473:pathology
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Lyme Borreliosis