Hearing loss in individuals at risk for neurosyphilis

Abstract

Otosyphilis is a serious complication of syphilis. 329 participants enrolled in a study of cerebrospinal fluid (CSF) abnormalities in syphilis underwent portable audiometry (250 Hz to 8000 Hz at 5–75 dB); it was repeated in 33 after otosyphilis treatment. Treponema pallidum spp pallidum ( T. pallidum) DNA in blood was quantitated by polymerase chain reaction. Odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were determined by logistic, ordinal or Cox regression. 166 (50.5%) had normal hearing; 15 (4.6%) had low frequency (LF) loss alone, 93 (28.3%) had high frequency (HF) loss alone, and 55 (16.7%) had both. Adjusted odds of any hearing loss were higher with detectable blood T. pallidum DNA (3.00 [1.58–5.69], p = 0.001), CSF pleocytosis (2.02 [1.12–3.66], p = 0.02), and older age (2.22 per 10-year increase, [1.70–2.91], p < 0.001). HRs of normalization of LF and HF loss were lower for older individuals (0.20 [0.07–0.63, p = 0.005] and 0.22 [0.05–0.94, p = 0.04]), and HRs for normalization of HF loss were lower for those with more severe loss (0.09 [0.02–0.43], p = 0.002), and in those with CSF pleocytosis (0.32 [0.11–0.96], p = 0.04). Older age and CSF pleocytosis increase the likelihood of otosyphilis and impair hearing recovery after otosyphilis treatment.

Clinical Features and Corrected Factors with Neurosyphilis in HIV/Syphilis Co-Infected Patients Based on Stage of Syphilis

“…Neurosyphilis is a complicated and serious condition that can occur if syphilis treatment is delayed or not properly performed in the early stage. Late-stage neurosyphilis can cause permanent central nervous system damage even after proper treatment, leading to conditions such as dementia, 11 blindness, 12 hearing loss, 13 and paralysis. 14 In HIV/syphilis co-infected patients, it is extremely important to promptly diagnose neurosyphilis, especially in the asymptomatic stage.…”

Absolute blood lymphocytes/monocytes and lymphocytes/neutrophils in patients with neurosyphilis may affect the response to therapy and diagnostic efficacy

“…NS patients have a variety of clinical manifestations, including but not limited to ocular syphilis, otosyphilis, central nervous system damage, etc., which can manifest as visual impairment, hearing loss, memory loss, mental abnormalities, etc. [1][2][3] . However, at the same time, these patients can also be clinically asymptomatic, and if the diagnosis and treatment are not timely, they can experience sequelae and even lifethreatening conditions.…”

“…At present, the treatment of NS is the rst choice of continuous intravenous infusion of 10~14 days of penicillin 18 million ~ 24 million U/d, and the clinical symptoms of NS patients may improve after treatment, but other neuropsychiatric symptoms still need to be treated symptomatically. Clinically, the treatment effect is usually judged based on cerebrospinal uid (CSF) and the improvement of clinical symptoms, but it is impossible to prove whether the improvement of symptoms after symptomatic treatment is caused by plum removal treatment [2,3] . At the same time, the e cacy of treatment cannot be determined for some asymptomatic infections, so it is particularly important to recheck CSF after treatment [4] .…”