Sudden onset unilateral sensorineural hearing loss after rabies vaccination

Abstract

SUMMARYA 33-year-old man developed profound sudden onset right-sided hearing loss with tinnitus and vertigo, within 24 h of pretravel rabies vaccination. There was no history of upper respiratory tract infection, systemic illness, ototoxic medication or trauma, and normal otoscopic examination. Pure tone audiograms (PTA) demonstrated right-sided sensorineural hearing loss (thresholds 90-100 dB) and normal left-sided hearing. MRI internal acoustic meatus, viral serology (hepatitis B, C, HIV and cytomegalovirus) and syphilis screen were normal. Positive Epstein-Barr virus IgG, viral capsid IgG and anticochlear antibodies (anti-HSP-70) were noted. Initial treatment involved a course of high-dose oral prednisolone and acyclovir. Repeat PTAs after 12 days of treatment showed a small improvement in hearing thresholds. Salvage intratympanic steroid injections were attempted but failed to improve hearing further. Sudden onset sensorineural hearing loss (SSNHL) is an uncommon but frightening experience for patients. This is the first report of SSNHL following rabies immunisation in an adult. BACKGROUND

Tinnitus following COVID-19 vaccination: report of three cases

“…Tinnitus following immunisation is uncommon. It has been reported after hepatitis B, rabies, measles and H1N1 vaccines, associated to SNHL (Okhovat et al 2015). With regard to Pfizer vaccine against SARS-CoV-2, there was no mention of tinnitus in the article regarding its safety and efficacy (Polack et al 2020).…”

Sudden sensorineural hearing loss after COVID-19 vaccination

“…Viral antigens after vaccination could induce immunologic response resulting in release of antibodies and cytokines. Immunocomplex mediation could cause autoimmune response directing antibodies to the cochlea (Okhovat et al, 2015). Immunologic and inflammatory responses might result in vasculitis and vascular ischemia of the cochlea.…”

“…Sudden sensorineural hearing loss (SSNHL) is defined as hearing loss ≥30 dB over three consecutive frequencies within three days (Okhovat et al, 2015, Chandrasekhar et al, 2019, Kolarov et al, 2019. The etiology of SSNHL usually is idiopathic, but it can be attributed to viral infection, vasculitis, autoimmune disease, and tumor (Baxter et al, 2016, De Marco et al, 2018, Chandrasekhar et al, 2019.…”

Audiovestibular Disorders after COVID-19 Vaccine: Is There an Association?

“…Several reports of SSNHL after immunization with commonly used vaccines, such as rabies, hepatitis B, measles, and H1N1, are currently reported in the literature [ 36 , 37 , 38 , 39 , 40 , 41 ].…”