Syphilitic otitis may occur with either congenital or any stage of acquired syphilis. It may be an unexpected cause for a variety of hearing or vestibular disorders.


Key features:

(1) onset of deafness and/or a vestibular disorder

(2) positive syphilis serology


Features of congenital syphilitic otitis:

(1) bilateral deafness without vertigo


Features of acquired syphilitic otitis:

(1) asymmetric sensorineural hearing loss

(2) tinnitus

(3) vertigo

The presence of all 3 findings may result in the diagnosis of Meniere's disease (cochleovestibular dysfunction).


Screening tests for syphilis can be nonspecific. Any positive reaction should be followed by a specific test that excludes false positive reactions.


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