gms | German Medical Science

Introduction: Although initially declining after the introduction of penicillin in the 1940’s, the global incidence of syphilis cases has been rising again since 2000 and the topic has gained new importance in view of the global HIV epidemic. WHO data shows increased prevalence especially in South-East-Asia, Eastern Europe and the US. It is on this background that we aim to provide a local case series of patients treated for otosyphilis.

Methods: In this single institution, comparative, observational, retrospective case series, a total of 33 patients who underwent treatment for otosyphilis over the past 25 years have been included. Serology was obtained. A comparison of outcome was made between 2 anti-treponemal agents: amoxicillin and penicillin.

Results: Mean age of presentation was 67.70 years, the male:female ratio was 2:1. Main presenting complaints were hearing loss in 28 (84.84%) cases, vertigo in 13 (39.39%) cases and tinnitus in 10 (30.30%) patients. Treatment regimens were either amoxicillin or penicillin. The patients were followed up for a mean of 14.8 months. On follow up, parameters like serology, hearing loss, vertigo and tinnitus have been investigated.

Conclusion: In consideration of the again rising incidence of syphilis, otosyphilis remains a valid differential diagnosis in common ENT practice. Although hearing loss and vertigo are main presenting complaints, other patterns of presentation can be seen. Given the potentially hazardous outcome, early detection is important. 2 effective treatment regimens were shown in this study.

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