Congenital syphilitic deafness

Kerr, A. G.; Smyth, G. D. L.; Cinnamond, M. J.

doi:10.1017/s0022215100076556

Cited by 22 publications

(8 citation statements)

References 10 publications

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“…This was the only 'dead' ear in this series in which any improvement was noted, and the improvement was of little benefit to the patient (speech score eight per cent). This is consistent with earlier reports by Kerr et al (1973), Perlman and Leek (1952) and Dobbin and Perkins (1983).…”

Section: Discussionsupporting

confidence: 94%

“…By 1973 it had become our standard policy in treatment of congenital syphilitic labyrinthitis to use ampicillin and prednisone together as the first line of treatment (Kerr et al, 1973). Later some of the patients who responded initially to ampicillin and prednisone failed to maintain their hearing and as a result long term ACTH was introduced for these patients, again with encouraging results.…”

Section: Clinical Backgroundmentioning

confidence: 99%

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Syphilitic labyrinthitis – an update

1995

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Forty-eight patients with syphilitic labyrinthitis have been treated and followed up for periods of six months to 25 years; interpretation of the hearing results must be in the light of the natural history of this condition which is perceived to be progression of hearing loss to profound deafness.At the beginning of the series treatment was with ampicillin alone and on this treatment 11 ears with useful hearing were maintained at this level. The group with combined ampicillin and prednisone treatment, which included some failures from ampicillin alone, maintained useful hearing in 28 out of 29 ears. Those treated initially with ampicillin and prednisone and later also given regular injections of ACTH, maintained hearing in 16 out of 17 ears.At the outset, there were 29 profoundly deaf ears. One of these recovered some useful hearing but two ears with useful hearing at the outset became profoundly deaf so that at the end there were 30 profoundly deaf ears. However, all patients as opposed to ears, with useful hearing at the outset were left with some hearing; no patient became profoundly deaf.

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Section: Discussionsupporting

confidence: 94%

Section: Clinical Backgroundmentioning

confidence: 99%

Syphilitic labyrinthitis – an update

1995

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“…36 This was based on the principle that the higher doses required for CNS penetration may also be required for perilymph penetration. 38 In five of our cases, the initial treatment was followed by a longer course of penicillin, either in the form of aqueous penicillin G, benzathine penicillin G, or amoxicillin plus probenicid. Based on the slow rate of growth of T. pallidum during the later stages of syphilis, as well as the recovery of the organism from the perilymph of a patient with otosyphilis who received three weekly doses of 2.4 million units of benzathine penicillin G, 39 a sustained presence of penicillin has been advocated for eradication.…”

Section: Discussionmentioning

confidence: 86%

Otosyphilis in HIV-Coinfected Individuals: A Case Series from Toronto, Canada

Mishra

Walmsley

Loutfy

et al. 2008

AIDS Patient Care and STDs

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We sought to identify and review the clinical features and treatment outcomes of eight recent cases of otosyphilis in HIV-positive patients seen in Toronto. All patients reported tinnitus, and seven (87.5%) reported subjective hearing loss. Not taking auditory findings into consideration, four patients would be classified as having secondary syphilis, three patients as having early latent syphilis, and one patient as having latent syphilis of unknown duration. The median CD4 cell count was 370 x 10(6)/L. All patients were treated with intravenous aqueous penicillin G with regimens recommended for the treatment of neurosyphilis; four patients received adjunctive steroids. All eight patients experienced improvement in tinnitus and four of the seven (57.1%) patients with symptomatic hearing loss also experienced improvement. Otosyphilis can occur in HIV-positive individuals despite high CD4 cell counts, and is potentially reversible. Increased awareness of uncommon manifestations of syphilis in high-risk individuals is warranted to prompt appropriate investigation and treatment.

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“…Throughout the follow-up, all patients had regular pure tone audiometry and assessment of speech discrimination (Kerr et al, 1973).…”

Section: Methodsmentioning

confidence: 99%

“…A review of the treatment of congenital syphilitic deafness in Belfast was presented at a meeting of the Section of Otology of the Royal Society of Medicine in March 1972 (Kerr et al, 1973). In the 12 cases with residual hearing the symptomatic progress of the disease had been reversed or halted for up to four years, using various combinations of antibiotics and steroids.…”

mentioning

confidence: 99%

Congenital syphilitic deafness—a further review

et al. 1983

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Initial optimism about the successful outcome of treatment of congenital syphilitic deafness with ampicillin and steroids has always been tempered with an awareness of the uncertain long-term results. This paper is a review of 16 patients treated with various combinations of ampicillin and steroid; these have been followed up for periods of five to 14 years. Ampicillin alone does not prevent progressive hearing loss in the majority of patients. Ampicillin combined with prednisone, or with prednisone and ACTH, has preserved the hearing in all but two ears which had useful hearing before treatment The fact that the hearing in many of these ears, although maintained continues to fluctuate still gives cause for concern.

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Congenital syphilitic deafness

Cited by 22 publications

References 10 publications

Syphilitic labyrinthitis – an update

Syphilitic labyrinthitis – an update

Otosyphilis in HIV-Coinfected Individuals: A Case Series from Toronto, Canada

Congenital syphilitic deafness—a further review

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