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Reversible hearing loss following cryptococcal meningitis: case study

Published online by Cambridge University Press:  23 May 2016

W L Neo*
Affiliation:
Department of Otolaryngology, Tan Tock Seng Hospital, Singapore
N Durisala
Affiliation:
Department of Audiology, Tan Tock Seng Hospital, Singapore
E C Ho
Affiliation:
Department of Otolaryngology, Tan Tock Seng Hospital, Singapore
*
Address for correspondence: Dr Wei Li Neo, Blk 22 Queen's Close #17–157, Singapore 140022 E-mail: [email protected]

Abstract

Background:

Sensorineural hearing loss is a recognised complication of cryptococcal meningitis. The mechanism of hearing loss in patients with cryptococcal meningitis is different from that in bacterial meningitis.

Case report:

An immune-competent man with cryptococcal meningitis presented with sudden onset, bilateral, severe to profound sensorineural hearing loss and vestibular dysfunction. He was initially evaluated for cochlear implantation. However, he had a significant recovery; he no longer required surgery and was able to cope without a hearing aid.

Conclusion:

Typically, cochlear implantation is performed with some urgency in patients with hearing loss post-bacterial meningitis, because of the risk of labyrinthitis ossificans. However, this process has not been described in patients with cryptococcal meningitis. Furthermore, patients with hearing loss associated with cryptococcal meningitis have shown varying degrees of reversibility. In this case report, hearing loss from cryptococcal meningitis is compared with that from bacterial meningitis, and the need for cochlear implantation in patients with cryptococcal meningitis is discussed.

Type
Clinical Record
Copyright
Copyright © JLO (1984) Limited 2016 

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Footnotes

Presented at the 30th Politzer Society Meeting and 1st World Congress of Otology, 30 June – 3 July 2015, Niigata, Japan.

References

1Hughes, KV 3rd, Green, JD Jr, Alvarez, S, Reimer, R.Vestibular dysfunction due to cryptococcal meningitis. Otolaryngol Head Neck Surgery 1997;116:536–40Google Scholar
2Chayakulkeeree, M, Perfect, JR.Cryptococcosis. Infect Dis Clin North Am 2006;65:507–44Google Scholar
3Lewis, JL, Rabinovich, S.The wide spectrum of cryptococcal infections. Am J Med 1972;53:315–21Google Scholar
4Day, JN, Hoang, TN, Duong, AV, Hong, CT, Diep, PT, Campbell, JI et al. Most cases of cryptococcal meningitis in HIV-uninfected patients in Vietnam are due to a distinct amplified fragment length polymorphism-defined cluster of cryptococcus neoformans var. grubii VN1. J Clin Microbiol 2011;49:658–64Google Scholar
5Pukkila-Worely, R, Mylonakis, E.Epidemiology and management of cryptococcal meningitis: developments and challenges. Expert Opin Pharmacother 2008;9:551–60Google Scholar
6Wang, HC, Chang, WN, Lui, CC, Peng, JP, Huang, CR, Chang, HW et al. The prognosis of hearing impairment complicating HIV-negative cryptococcal meningitis. Neurology 2005;65:320–2CrossRefGoogle ScholarPubMed
7Moberly, AC, Naumann, IC, Cordes, SR.Cryptococcal meningitis with isolated otologic symptoms. Am J Otolaryngol 2010;31:4953Google Scholar
8Low, WK.Cryptococcal meningitis: implications for the otologist. ORL J Otorhinolaryngology Relat Spec 2002;64:35–7Google Scholar
9Maslan, MJ, Graham, MD, Flood, LM.Cryptococcal meningitis: presentation as sudden deafness. Am J Otol 1985;6:435–7Google Scholar
10Mori, T, Suzuki, H, Hiraki, N, Hashida, K, Ohbuchi, T, Katoh, A.Prediction of hearing outcomes by distortion product otoacoustic emissions in patients with idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx 2011;38:564–9Google Scholar
11Mayer, JM, Chevalier, X, Albert, E, Casteran, JM, Boutin, B, Ponsot, G et al. Reversible hearing loss in a patient with cryptococcosis. Arch Otolaryngol Head Neck Surg 1990;116:962–4Google Scholar
12Igarishi, M, Weber, SC, Alford, BR, Coats, AC, Jerger, J.Temporal bone findings in cryptococcal meningitis. Arch Otolaryngol 1975;101:577–83CrossRefGoogle Scholar
13McGill, T.Mycotic infections of the temporal bone. Arch Otolaryngol 1978;104:140–4Google Scholar
14Harada, T, Sando, I, Myers, EN.Temporal bone histopathology in deafness due to cryptococcal meningitis. Ann Otol Rhinol Laryngol 1979;88:630–6CrossRefGoogle ScholarPubMed
15Caye-Thomson, P, Dam, MS, Omland, SH, Mantoni, M.Cochlear ossification in patients with profound hearing loss following bacterial meningitis. Acta Otolaryngol 2012;132:720–5Google Scholar