Otosyphilis: A Review of the Literature

Abstract

The number of cases of syphilis has increased in the United States and in many high-income nations. Otosyphilis is a less recognized complication of syphilis that can lead to irreversible sensorineural hearing loss. Different pathophysiological mechanisms have been proposed to explain hearing loss in otosyphilis. We review the literature on otosyphilis in adults and propose the need for future work in this field to identify better ways to diagnose, treat, and manage this disease. Patients with syphilis should be screened routinely for hearing loss, and all patients with new, sudden, or fluctuating sensorineural hearing loss should be evaluated for syphilis.

Otosyphilis with Clinical and Serologic Responses with Weekly Intramuscular Penicillin: A Case Report and Literature Review

“…Otosyphilis is one of the complications of syphilis that may lead to deafness and other complications if untreated [4]. Otosyphilis can occur at any stage of syphilis [7].…”

“…Despite available preventive and therapeutic strategies, more advanced disease forms occur [3]. Otosyphilis can occur at any stage of the disease, and it is suggested that patients with syphilis be routinely evaluated for otologic symptoms [4]. If not diagnosed early, otosyphilis may cause irreversible hearing loss and further progression of the disease [5].…”

Hearing loss in individuals at risk for neurosyphilis

“…4–6 Otosyphilis, or hearing loss due to syphilis, is an important complication of syphilis, but less is known about it, largely because few studies have systematically addressed the problem in individuals with active syphilis. 7 For example, studies from the 1980s and 1990s defined otosyphilis as reactive serum fluorescent treponemal antibody absorption test and hearing loss of unknown etiology; only 22% of patients who met these criteria actually had otosyphilis. 8…”

A 2021 Update on Syphilis: Taking Stock from Pathogenesis to Vaccines

“…Otosyphilis can manifest with a variety of audiovestibular symptoms (hearing loss is the main one). TP may also affect the eighth cranial nerve, the cochleovestibular apparatus, or the temporal bone [30].…”

“…Otosyphilis can manifest with a variety of audiovestibular symptoms (hearing loss is the main one). TP may also affect the eighth cranial nerve, the cochleovestibular apparatus, or the temporal bone [30].  Early latent syphilis refers to the asymptomatic period between primary and secondary or late syphilis.…”