Hearing loss and accompaning disturbance of Neurobrucellosis cases

ABSTRACT

Up to 5-10% of Brucellosis cases manifest with neurobrucellosis and course with various forms such as meningocephalitis, cerebellitis, acute meningitis, myelopathy, radiculopathy neuropsychiatric syndromes and cranial neuropathy. Brucella toxin damages the inner ear and leads to sensorineural hearing loss. We aim to report seven patients who were diagnosed as neurobrucellosis accompanying with hearing loss problem and were hospitalized to Infectious Diseases Department between 2005 and 2010. Long term fever, headache, hearing loss, walking disability were the predominant symptoms, Bilateral sensorineural hearing loss was the most frequent finding. And the other findings were also dysarthria, ataxia walking and increased deep tendon reflexes. Common symptoms were long term fever [100%], headache [71.4%], chills [57%], vomiting and exhaustion [29%]. Neurologic findings such as walking instability [four patients], paraplegia [two patients] and hearing disturbances [seven patients] were recognized. Rifampicin, doxycycline and trimethoprim/ sulfamethaxazole agents were administered to our patients and the duration of treatment should be decided depending upon individual cases [4-12 months]. Hearing thresholds were restored after treatment in five patients. Only two patients' hearing loss were partially improved after therapy. Neurobrucellosis should be considered in long term fever accompanying the unexplained neurological symptoms such as hearing loss. In neurobrucellosis patient should be tested in hearing thresholds