Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-24T17:00:35.487Z Has data issue: false hasContentIssue false

Evoked response audiometry in scrub typhus: prospective, randomised, case–control study

Published online by Cambridge University Press:  04 March 2011

J S Thakur*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Indira Gandhi Medical College, Shimla, 171001, HP, India
N K Mohindroo
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Indira Gandhi Medical College, Shimla, 171001, HP, India
D R Sharma
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Indira Gandhi Medical College, Shimla, 171001, HP, India
K Soni
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Indira Gandhi Medical College, Shimla, 171001, HP, India
S S Kaushal
Affiliation:
Department of Medicine, Indira Gandhi Medical College, Shimla, 171001, HP, India
*
Address for correspondence: Dr Jagdeep S Thakur, Dept of Otolaryngology-Head and Neck Surgery, Indira Gandhi Medical College, Shimla, HP, 171001, India. Fax: +91 177 2800224 E-mail: [email protected]; [email protected]

Abstract

Objective:

To investigate the hypothesis of cochlear and retrocochlear damage in scrub typhus, using evoked response audiometry.

Study design:

Prospective, randomised, case–control study.

Methods:

The study included 25 patients with scrub typhus and 25 controls with other febrile illnesses not known to cause hearing loss. Controls were age- and sex-matched. All subjects underwent pure tone audiometry and evoked response audiometry before commencing treatment.

Results:

Six patients presented with hearing loss, although a total of 23 patients had evidence of symmetrical high frequency loss on pure tone audiometry. Evoked response audiometry found significant prolongation of absolute latencies of wave I, III, V, and wave I–III interpeak latency. Two cases with normal hearing had increased interpeak latencies. These findings constitute level 3b evidence.

Conclusion:

Findings were suggestive of retrocochlear pathology in two cases with normal hearing. In other patients, high frequency hearing loss may have led to altered evoked response results. Although scrub typhus appears to cause middle ear cochlear and retrocochlear damage, the presence of such damage could not be fully confirmed by evoked response audiometry.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Watt, G. Scrub typhus. In: Warrell, DA, Cox, TM, Firth, JD, Benz, EJ Jr, eds. Oxford Text Book of Medicine, 4th edn.Oxford: Oxford University Press, 2003;629–31Google Scholar
2Didier, R. Orientia tsutsugamushi (scrub typhus). In: Mandell, GL, Bennett, JE, Dolin, R, eds. Mandell, Douglas, Bennett's Principles and Practice of Infectious Diseases, 7th edn.Philadelphia: Churchill Livingstone, 2010Google Scholar
3Walker, DH, Dumler, JS, Marrie, T. Rickettsial diseases. In: Fauci, AS, Kasper, DL, Longo, DL, Braunwald, E, Hauser, SL, Jameson, JL, Loscalzo, J, eds. Harrison's Principles of Internal Medicine, 17th edn.Chicago: McGraw-Hill, 2008:1059–67Google Scholar
4Mahajan, SK, Bakshi, J. Acute reversible hearing loss in scrub typhus. J Assoc Physician India 2007;55:512–14Google ScholarPubMed
5Premaratna, R, Chandrasena, TG, Dassayake, AS, Loftis, AD, Dasch, GA, de Silva, HJ. Acute hearing loss due to scrub typhus: a forgotten complication of a reemerging disease. Clin Infect Dis 2006;42:e68CrossRefGoogle ScholarPubMed
6Kim, JH, Lee, SA, Ahn, TB, Yoon, SS, Park, KC, Chang, DI et al. Polyneuropathy and cerebral infarction complicating scrub typhus. J Clin Neurol 2008;4:36–9CrossRefGoogle ScholarPubMed
7Kang, JI, Kim, DM, Lee, J. Acute sensorineural hearing loss and severe otalgia due to scrub typhus. BMC Infect Dis 2009;9:173CrossRefGoogle ScholarPubMed
8Sexton, DJ. Acute hearing loss and rickettsial diseases. Clin Infect Dis 2006;42:1506CrossRefGoogle ScholarPubMed
9Toerner, JG, Kumar, PN, Garagusi, VF. Guillain-Barré syndrome associated with Rocky Mountain spotted fever: case report and review. Clin Infect Dis 1996;22:1090–1CrossRefGoogle ScholarPubMed
10Friedmann, I, Frohlich, A, Wright, A. Epidemic typhus fever and hearing loss: a histopathological study. J Laryngol Otol 1993;107:275–83CrossRefGoogle Scholar
11Stach, BA. Audiological evaluation of otological/neurotological disease. In: Glasscock, ME, Gulya, AJ, eds. Surgery of the Ear, 5th edn.New Delhi: BC Decker, 2003;158200Google Scholar
12Coats, AC. Human auditory nerve action potentials and brain stem evoked responses: Latency-intensity functions in detection of cochlear and retrocochlear abnormality. Arch Otolaryngol 1978;104:709–17CrossRefGoogle Scholar
13Coats, AC, Martin, JL. Human auditory nerve action potentials and brain stem evoked responses: effects of audiogram shape and lesion location. Arch Otolaryngol 1977;103:605–22CrossRefGoogle ScholarPubMed
14Jerger, J. Prediction of sensorineural hearing level from the brain stem evoked response. Arch Otolaryngol 1978;104:456–61CrossRefGoogle ScholarPubMed
15Jerger, J, Johnson, K. Interactions of age, gender, and sensorineural hearing loss on ABR latency. Ear Hear 1988;9:168–76CrossRefGoogle ScholarPubMed
16Yamada, O, Kodera, K, Yagi, T. Cochlear processes affecting wave V latency of the auditory evoked brain stem response. A study of patients with sensory hearing loss. Scand Audiol 1979;8:6770CrossRefGoogle ScholarPubMed
17Elberling, C, Parbo, J. Reference data for ABRs in retro cochlear diagnosis. Scand Audiol 1987;16:4955CrossRefGoogle Scholar