Hearing impairment as an unusual presenting sign of Cryptococcus gattii meningoencephalitis

2021 ◽  
Vol 14 (4) ◽  
pp. e239040
Author(s):  
Sophie Gong ◽  
Pirathaban Sivabalan ◽  
Damon P Eisen
Keyword(s):  
Hearing Loss ◽  
Literature Review ◽  
Hearing Impairment ◽  
Case Series ◽  
Cryptococcus Gattii ◽  
Persistent Headache ◽  
Hiv Negative

Hearing loss is an unusual presenting feature of Cryptococcus gattii meningoencephalitis. Two cases of HIV-negative patients who presented with hearing loss are discussed and a literature review of published cases was conducted. Possible mechanisms for hearing loss with C. gattii infection are explored. This case series aims to raise awareness among clinicians that hearing loss can be a concerning feature in patients with persistent headache necessitating further investigation.

scholarly journals Hearing Impairment Among Children Referred to a Public Audiology Clinic in Gaborone, Botswana

2018 ◽  
Vol 5 ◽  
pp. 2333794X1877007
Author(s):  
Francis M. Banda ◽  
Kathleen M. Powis ◽  
Agnes B. Mokoka ◽  
Moalosi Mmapetla ◽  
Katherine D. Westmoreland ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Confidence Interval ◽  
Hearing Impairment ◽  
Case Series ◽  
Retrospective Case ◽  
Screening Programs ◽  
Care Workers ◽  
Sensorineural Hearing Impairment ◽  
Awareness Programs ◽  
Conductive Hearing

Objective. To describe and quantify hearing impairment among children referred to the audiology clinic in Princess Marina Hospital, a public referral hospital in Botswana. Methods. In a retrospective case series, we reviewed medical records of children aged 10 years and younger whose hearing was assessed between January 2006 and December 2015 at the audiology clinic of Princess Marina Hospital in Gaborone, Botswana. Results. Of 622 children, 50% were male, and median age was 6.7 years (interquartile range = 5.0-8.3). Hearing impairment was diagnosed in 32% of clinic attendees, comprising sensorineural (23%), conductive (25%), and mixed (11%) hearing loss, while 41% of children with diagnosed hearing impairment did not have a classification type. Hearing impairment was mild in 22.9%, moderate in 22.4%, severe in 19.4%, profound in 16.9%, and of undocumented severity in 18.4%. Children younger than 5 years were 2.7 times (95% confidence interval = 1.29-5.49; P = .008) more likely to be diagnosed with sensorineural hearing impairment compared with those older than 5 years. By contrast, children older than 5 years were 9.6 times (95% confidence interval = 2.22-41.0; P = .002) more likely to be diagnosed with conductive hearing loss compared with those under 5 years. Conclusion. Hearing impairment was common among children referred to this audiology clinic in Botswana. Of those with hearing impairment, more than a third had moderate or severe deficits, suggesting that referrals for hearing assessments are not occurring early enough. Hearing awareness programs individually tailored to parents, educators, and health care workers are needed. Neonatal and school hearing screening programs would also be beneficial.

scholarly journals The evolution of children hearing loss: Research progress on recent trends and advances

2021 ◽  
Vol 271 ◽  
pp. 04023
Author(s):  
Xinyang Wang
Keyword(s):  
Hearing Loss ◽  
Literature Review ◽  
Hearing Impairment ◽  
Daily Life ◽  
Research Progress ◽  
Common Disease ◽  
Great Progress ◽  
Great Pressure ◽  
Recent Trends ◽  
Made In

Hearing impairment is a common disease, affecting about five percent of the population. It puts great pressure on children, their families and society, and has become an significant problem affecting daily life. In recent years, great progress has been made in the study of hearing loss in children. This paper describes the ear structure, the causes of hearing impairment, the assessment and diagnosis of hearing impairment and the current applicable treatment methods through literature review. Previous research on hearing loss in children is summarized in this paper and provides some references for the further research.

SUSAC'S SYNDROME: A CASE SERIES FROM A REGIONAL NEUROSCIENCES UNIT

2015 ◽  
Vol 86 (11) ◽  
pp. e4.34-e4 ◽  
Author(s):  
Dominic King ◽  
Jason Philip Appleton ◽  
Saiju Jacob
Keyword(s):  
Hearing Loss ◽  
Literature Review ◽  
Case Series ◽  
Disease Course ◽  
Susac’S Syndrome ◽  
Immune Mediated ◽  
Relapsing Remitting ◽  
Retinal Artery ◽  
Management Techniques ◽  
Clinical Triad

The clinical triad of branch retinal artery occlusions, hearing loss and encephalopathy constitutes Susac's Syndrome. This rare, immune mediated, microangiopathic disorder shows a variable course with a preponderance of 3 to 1 for women, mainly in their 2nd to 4th decade. The condition relies on diagnosis and early aggressive immunosuppressive therapy to avoid severe sequale. Unfortunately, due to the paucity of experience, and a variable disease course, often lacking all elements of the triad concurrently, diagnosis continues to be delayed.We present five cases (Age 34–45, M:F–1:4) seen at our regional neurosciences centre, which highlight the diagnostic differences and challenges and the variety of management techniques adopted. Three patients had a monophasic illness and two had a relapsing remitting course. In addition, we provide an up-to-date literature review on the pathophysiology, diagnosis and management of this rare and fascinating condition.Susac's disease, otherwise described as retinocochleocerebral vasculopathy, RED-M (retinopathy, encephalopathy, deafness associated microangiopathy) and SICRET (small infarcts of cochlear, retinal and encephalic tissues), is a syndromic pathology requiring the recognition of a triad of deficits to make a diagnosis. The relevance of this and the difficulty in diagnosis is exemplified in the cases presented here.

scholarly journals Hearing Disorders among HIV Positive Children at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

2020 ◽  
pp. 1-9
Author(s):  
Charles Medo Vincent ◽  
Nsirimobu Ichendu Paul
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Otitis Media ◽  
Hiv Positive ◽  
Hiv Disease ◽  
Hearing Disorders ◽  
Mild Degree ◽  
Port Harcourt ◽  
Negative Controls ◽  
Hiv Negative

Background: Use of antiretroviral drugs (ART) has changed the epidemiology of HIV disease, making it a chronic illness and with many people developing long term sequelae of the disease such as hearing loss. This study compared hearing disorders, its types and severity among children with and without HIV disease. Methods: This was a hospital based comparative cross-sectional study carried out among eligible patients who were HIV positive, aged 6 to 15 years recruited via systematic sampling method and matched by age and sex with HIV negative controls. An interviewer-administered questionnaire was used to extract the sociodemographic characteristics of the subjects, patients/caregivers awareness of hearing impairment and to document the otoscopic, Pure tone audiometry (PTA) and tympanometry findings performed on the patients. CD4 count was done for all the study participants while all HIV positive patients were graded for severity using WHO clinical Staging. Obtained data was analysed using the statistical package for social sciences (SPSS) version 22. A p-value of less than 0.05 was considered statistically significant. Results: A total of 400 children aged 6 years to 15 years were recruited for the study out of which 200 were HIV positive (cases), while 200 were HIV negative (controls). Otitis media with effusion, otitis media and perforated tympanic membrane were the predominant tympanometry and otoscopic findings.  Seventy-three (36.5%) of the HIV positive patients had hearing loss compared to 19(9.5%) of HIV negative patients and this was statistically significant (X2 = 41.1; p = 0.0001). Majority (95.9%) of persons with hearing loss had the conductive type and of mild degree 53 (72.6%). Only 3(4.1%) caregivers of the HIV positive children and 1 (5.6%) caregiver of the HIV negative children were aware of the hearing impairment in their children but none had complained to their primary health caregivers. Conclusion: This study has established a higher rate of hearing loss, of the conductive type and of mild degree among HIV positive patient. It is necessary to assess and monitor the hearing in HIV positive children by conducting interval PTA testing and Tympanometry to ensure timely intervention since parental awareness is poor.

scholarly journals Ophthalmic manifestations of Cryptococcus gattii species complex: a case series and review of the literature

2022 ◽  
Vol 15 (1) ◽  
pp. 119-127
Author(s):  
Grace A. McCabe ◽  
◽  
Todd Goodwin ◽  
Douglas F. Johnson ◽  
Anthony Fok ◽  
...  
Keyword(s):  
Literature Review ◽  
Intracranial Hypertension ◽  
Species Complex ◽  
Visual Loss ◽  
Case Series ◽  
The United States ◽  
Cryptococcus Gattii ◽  
Complication Rates ◽  
Presenting Symptoms ◽  
Ophthalmic Manifestations

AIM: To report 4 cases of Cryptococcus gattii (C. gattii) species complex infection with diverse ophthalmic manifestations, and to review the literature to examine pathobiology of disease, classical ophthalmic presentations and outcomes, and treatment modalities for this emerging pathogen. METHODS: Cases of C. gattii meningoencephalitis with ophthalmic manifestations were identified via chart review at two institutions in Australia and one institution in the mid-west region of the United States and are reported as a case series. Additionally, a MEDLINE literature review was conducted to identify all reported cases of C. gattii with ophthalmic manifestations from 1990-2020. Cases were reviewed and tabulated, together with our series of patients, in this report. RESULTS: Four cases of C. gattii with ophthalmic manifestations are presented; three from Australia and one from the USA. A literature review identified a total of 331 cases of C. gattii with visual sequelae. The majority of cases occurred in immunocompetent individuals. Blurred vision and diplopia were the most common presenting symptoms, with papilloedema the most common sign, reported in 10%-50% of cases. Visual loss was reported in 10%-53% of cases, as compared to rates of visual loss of 1%-9% in C. neoformans infection. Elevated intracranial pressure, cerebrospinal fluid (CSF) fungal burden, and abnormal neurological exam at presentation correlated with poor visual outcomes. The mainstays of treatment are anti-fungal agents and aggressive management of intracranial hypertension with serial lumbar punctures. CSF diversion procedures should be considered for refractory cases. Acetazolamide and mannitol are associated with high complication rates, and adjuvant corticosteroids have demonstrated higher mortality rates; these treatments should be avoided. CONCLUSION: Permanent visual loss represents a devastating yet potentially preventable sequelae of C. gattii infection. Intracranial hypertension needs to be recognised early and aggressively managed. Referral to an ophthalmologist/neuro-ophthalmologist in all cases of cryptococcal infection independent of visual symptoms at time of diagnosis is recommended.

Effect of Computerized Auditory Training on Speech Perception of Adults With Hearing Impairment

2013 ◽  
Vol 20 (3) ◽  
pp. 91-106 ◽  
Author(s):  
Rachel Pizarek ◽  
Valeriy Shafiro ◽  
Patricia McCarthy
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Literature Review ◽  
Low Cost ◽  
Experimental Designs ◽  
Auditory Training ◽  
Hearing Impairments ◽  
Communicative Disorders ◽  
And Training

Computerized auditory training (CAT) is a convenient, low-cost approach to improving communication of individuals with hearing loss or other communicative disorders. A number of CAT programs are being marketed to patients and audiologists. The present literature review is an examination of evidence for the effectiveness of CAT in improving speech perception in adults with hearing impairments. Six current CAT programs, used in 9 published studies, were reviewed. In all 9 studies, some benefit of CAT for speech perception was demonstrated. Although these results are encouraging, the overall quality of available evidence remains low, and many programs currently on the market have not yet been evaluated. Thus, caution is needed when selecting CAT programs for specific patients. It is hoped that future researchers will (a) examine a greater number of CAT programs using more rigorous experimental designs, (b) determine which program features and training regimens are most effective, and (c) indicate which patients may benefit from CAT the most.

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