Sudden deafness as an initial presentation of varicella: case report and literature review.

Varicella, or chickenpox, is a highly contagious disease transmitted by the varicella zoster virus (VZV). Idiopathic sudden sensorineural hearing loss (ISSNHL) has been defined as a loss of at least 30 dB over at least three frequencies on audiogram within three days and with an uncertain cause. Deafness caused by varicella-zoster virus occasionally occurred in Ramsey hunter syndrome but associated with chickenpox is rare. We present a case of an adult varicella infection with sudden deafness as the first symptom. The patient begins with a sudden hearing loss in his left ear and developed fever 12 days later and skin rash 13 days later. He was diagnosed as chickenpox and received treatment of oral famciclovir capsule 250 mg administrated three times daily. After 2 weeks, at an outpatient follow-up the patient reported that while his scabs had fallen off and he felt well, the sudden deafness in the left ear had not improved. This kind of cases are rare and suggest the relationship between VZV and sudden deafness. Sudden deafness can be the first symptom of chickenpox. In this study, we also reviewed pathogenesis, clinical feature and the epidemiological character of chickenpox, the neurological complications of varicella zoster and the etiology of sudden deafness.

Correlation between serum lipid and prognosis of idiopathic sudden sensorineural hearing loss: a prospective cohort study.

BACKGROUND: To investigate the correlation between blood lipids and the prognosis of idiopathic sudden sensorineural hearing loss (ISSNHL). METHODS: We included 232 patients with ISSNHL at the Second Affiliated Hospital of Shanghai University from June 2015 to March 2017 using a prospective cohort study design. We collected information including age, gender, hypertension, diabetes, mellitus, vertigo, as well as the levels of blood total cholesterol (TC), triglycerides (TG), and low-density lipoproteins (LDL-C). We also recorded the ratio between the levels of low-density lipoproteins and the levels of high-density lipoproteins (LDL-C/HDL-C ratio). Correlations between the prognosis of ISSNHL and TC, TG, LDL-C, and LDL-C/HDL-C ratio were analyzed by univariable and multivariable logistic regression analyses. RESULTS: The clinical effectiveness rate of patients with TC ranging from 5.2 to 6.2 mmol/L was significantly higher than that of patients with TC <5.2 mmol/L (P<0.001). No notable difference was found between patients with TC <5.2 mmol/L and patients with TC ≥6.2 mmol/L. The clinical effectiveness rate of patients in TG ranging from 1.7 mmol/L to 2.3 mmol/L was markedly higher than those in TG <1.7 mmol/L (P<0.001). No significant difference was found between patients with TG ranging from 2.3 to 5.6 mmol/L, TG ≥5.6 mmol/L, and TG <1.7 mmol/L. The clinical effectiveness rate of patients in LDL-C/HDL-C <1.5 was considerably higher than those in LDL-C/HDL-C ranging from 1.5 to 2.5, 2.5 to 3.5, and ≥3.5 (P<0.001). CONCLUSIONS: Our findings indicated that TC, TG, and the LDL-C/HDL-C ratio are strongly associated with the prognosis of ISSNHL. These three indices could be recommended as independent markers to predict outcomes.