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Lyme disease: sudden hearing loss as the sole presentation

Published online by Cambridge University Press:  26 January 2015

C Espiney Amaro ,
P Montalvão ,
C Huins  and
J Saraiva
C Espiney Amaro*
Affiliation:
ENT Department, CUF Descobertas Hospital, Lisbon, Portugal Hyperbaric and Subaquatic Medical Centre of the Portuguese Navy, Lisbon, Portugal
P Montalvão
Affiliation:
ENT Department, CUF Descobertas Hospital, Lisbon, Portugal
C Huins
Affiliation:
ENT Department, Barts Royal London Hospitals, UK
J Saraiva
Affiliation:
ENT Department, CUF Descobertas Hospital, Lisbon, Portugal
*
Address for correspondence: Dr Carla Espiney Amaro, Rua Ilha Graciosa, n° 211, 2° frente, Quinta da Bela Vista, 2775-803 Sassoeiros, Portugal E-mail: dicacarla@hotmail.com
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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.

Conclusion:

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.

Keywords

Sudden Hearing LossLyme DiseaseLabyrinthitisLyme Borreliosis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 2 , February 2015 , pp. 183 - 186
Copyright
Copyright © JLO (1984) Limited 2015 

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References

1Centers for Disease Control and Prevention. Lyme Disease Data. In: http://www.cdc.gov/lyme/stats/index.html [24 November 2014]Google Scholar
2Rizzoli, A, Hauffe, HC, Carpi, G, Vourćh, GI, Neteler, M, Rosà, R. Lyme borreliosis in Europe. Euro Surveill 2011;16:19906Google Scholar
3Hubálek, Z. Epidemiology of Lyme borreliosis. Curr Probl Dermatol 2009;37:31–50Google Scholar
4Rauter, C, Hartung, T. Prevalence of Borrelia burgdorferi sensu lato genospecies in Ixodes ricinus ticks in Europe: a metaanalysis. Appl Environ Microbiol 2005;71:7203–16Google Scholar
5David de Morais, JA, Filipe, AR, Núncio, MS. Lyme disease in Portugal. Case report [in Portuguese]. Revista Portuguesa de Doenças Infecciosas 1989;12:261–76Google Scholar
6Lopes de Carvalho, I, Núncio, MS. Laboratory diagnosis of Lyme borreliosis at the Portuguese National Institute of Health (1990–2004). Euro Surveill 2006;11:257–60Google Scholar
7Fetterman, BL, Saunders, JE, Luxford, WM. Prognosis and treatment of sudden sensorineural hearing loss. Am J Otol 1996;17:529–36Google Scholar
8Mosnier, I, Bouccara, D, Sterkers, O. Sudden hearing loss in 1997: etiopathogenic hypothesis, management, prognostic factors and treatment [in French]. Ann Otolaryngol Chir Cervicofac 1997;114:251–66Google Scholar
9Stachler, RJ, Chandrasekhar, SS, Archer, SM, Rosenfeld, RM, Schwartz, SR, Barrs, DM et al. Clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg 2012;146(3 suppl):S1–35Google Scholar
10Byl, FM. Seventy-six cases of presumed sudden hearing loss occurring in 1973: prognosis and incidence. Laryngoscope 1977;87:817–25Google Scholar
11Byl, FM Jr. Sudden hearing loss: eight years' experience and suggested prognostic table. Laryngoscope 1984;94:647–61Google Scholar
12Chau, JK, Lin, JR, Atashband, S, Irvine, RA, Westerberg, BD. Systematic review of the evidence for the etiology of adult sudden sensorineural hearing loss. Laryngoscope 2010;120:1011–21Google Scholar
13Merchant, SN, Adams, JC, Nadol, JB. Pathology and pathophysiology of idiopathic sudden sensorineural hearing loss. Otol Neurotol 2005;26:151–60Google Scholar
14Hoen, AG, Margos, G, Bent, SJ, Diuk-Wasser, MA, Barbour, A, Kurtenbach, K et al. Phylogeography of Borrelia burgdorferi in the eastern United States reflects multiple independent Lyme disease emergence events. Proceedings of the National Academy of Sciences of the United States of America 2009;106:15013–18Google Scholar
15Stanek, G, Reiter, M. The expanding Lyme Borrelia complex-clinical significance of genomic species? Clin Microbiol Infect 2011;17:487–93Google Scholar
16British Infection Association. The epidemiology, prevention, investigation and treatment of Lyme borreliosis in United Kingdom patients: a position statement by the British Infection Association. J Infect 2011;62:329–38Google Scholar
17Stanek, G, Wormser, GP, Gray, J, Strle, F. Lyme borreliosis. Lancet 2012;379:461–73Google Scholar
18Rudenko, N, Golovchenko, M, Grubhoffer, L, Oliver, JH Jr. Updates on Borrelia burgdorferi sensu lato complex with respect to public health. Ticks Tick Borne Dis 2011;2:123–8Google Scholar
19Ertel, SH, Nelson, RS, Cartter, ML. Effect of surveillance method on reported characteristics of Lyme Disease, Connecticut, 1996–2007. Emerg Infect Dis 2012;18:242–7Google Scholar
20Girschick, HJ, Morbach, H, Tappe, D. Treatment of Lyme borreliosis. Arthritis Res Ther 2009;11:258Google Scholar
21Huppertz, HI, Girschick, HJ. Lyme borreliosis. In: Cimaz, R, Lehman, T, eds. Handbook of Systemic Autoimmune Diseases, Vol 6. Pediatrics in Systemic Autoimmune Diseases. Amsterdam: Elsevier BV, 2003Google Scholar
22Coumou, J, van der Poll, T, Speelman, P, Hovius, JW. Tired of Lyme borreliosis. Lyme borreliosis in the Netherlands. Neth J Med 2011;69:101–11Google Scholar
23Peltomaa, M, Pyykkö, I, Sappälä, I, Viitanen, L, Viljanen, M. Lyme borreliosis, an etiological factor in sensorineural hearing loss? Eur Arch Otorhinolaryngol 2000;257:317–22Google Scholar
24Logigian, EL, Kaplan, RF, Steere, AC. Chronic neurologic manifestations of Lyme disease. N Engl J Med 1990;323:1438–44Google Scholar
25Verbist, BM. Imaging of sensorineural hearing loss: a pattern-based approach to diseases of the inner ear and cerebellopontine angle. Insights Imaging 2012;3:139–53Google Scholar