一例罕见的耳梅毒引起的双侧前庭病报告。
A rare case report of bilateral vestibulopathy due to otosyphilis.
机构信息
Department of Neurology, Second Affiliated Hospital of Naval Medical University, Shanghai, Huangpu District, Shanghai, China.
出版信息
Medicine (Baltimore). 2024 May 17;103(20):e38149. doi: 10.1097/MD.0000000000038149.
RATIONALE
Bilateral vestibulopathy is an important cause of imbalance. There are multiple etiologies of bilateral vestibulopathy (BVP), but reports of BVP due to otosyphilis are rare.
PATIENT CONCERNS
A 39-year-old male was referred to our medical center due to vertigo, persistent dizziness and gait disturbance for 2 months.
DIAGNOSES
Bilateral vestibulopathy due to otosyphilis was considered in this case, as confirmed through analyses of vestibular function, laboratory tests, and penicillin treatment.
INTERVENTIONS
The patient was was treated with a high dose of penicillin G (24 × 106 IU/d) for 14 days.
OUTCOMES
The patient's symptoms had improved greatly following treatment, with dizziness and gait disturbance having completely resolved at 3 months following hospital discharge.
LESSONS
Bilateral vestibulopathy should be considered when evaluating patients with acute or subacute persistent dizziness. Clinicians should also be aware of the potential for otosyphilis among patients who report BVP.
背景
双侧前庭病变是导致失衡的一个重要原因。双侧前庭病变（BVP）有多种病因，但梅毒性双耳前庭病变的报告却很少。
病例介绍
一名 39 岁男性因眩晕、持续性头晕和步态不稳 2 个月就诊于我院。
诊断
根据前庭功能、实验室检查和青霉素治疗结果，考虑该患者为梅毒性双耳前庭病变。
干预措施
患者接受了为期 14 天的大剂量青霉素 G（24×106 IU/d）治疗。
结果
治疗后患者症状明显改善，出院后 3 个月头晕和步态不稳完全缓解。
结论
当评估急性或亚急性持续性头晕的患者时，应考虑双侧前庭病变。对于报告有双侧前庭病变的患者，临床医生还应注意梅毒的可能性。
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