Open AccessOtosyphilis and HIV: therapeutic dilemma and outcome of treatment
Author(s) -
Bruce John Mckenzie,
James Loock
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.01.2009.1464
Subject(s) - medicine , prednisone , penicillin , human immunodeficiency virus (hiv) , tone (literature) , pediatrics , antibiotics , surgery , immunology , art , literature , microbiology and biotechnology , biology
We present a case report and review the world literature concerning otosyphilis, particularly with reference to the HIV positive patient. Our patient received two separate courses of treatment for otosyphilis. A course of intramuscular penicillin and oral prednisone resulted in no improvement in his hearing thresholds. A subsequent course of intravenous penicillin and oral prednisone resulted in an improvement of 79 db in his three frequency pure tone average. Otosyphilis is one of the rare causes of treatable sensorineural hearing loss. HIV has been shown to increase the severity and the progression of luetic ear disease. This case reveals that the optimal treatment remains a 10 day course of intravenous penicillin and oral prednisone.