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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