Erythromycin-Induced Ototoxicity: Case Report

1994 ◽  
Vol 10 (4) ◽  
pp. 169-171 ◽  
Author(s):  
Desouky F. Fayed ◽  
Nabil S. Dahmash
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Lower Lobe ◽  
Blood Gases ◽  
Sensorineural Hearing ◽  
High Dose ◽  
Atypical Pneumonia ◽  
High Grade Fever ◽  
Arterial Blood ◽  
Immunosuppressed Patients

Objective: To report a case of erythromycin-induced ototoxicity and to discuss the occurrence of this event. Case Summary: A 26-year-old woman was admitted to the medical intensive care unit with a two-day history of progressive shortness of breath, high-grade fever, cough, and pleuritic chest pain. Arterial blood gases on room air showed severe hypoxemia, and a chest X-ray revealed right lower-lobe infiltrates. Provisional diagnosis was atypical pneumonia, for which erythromycin lactobionate 1 g q6h iv was administered. All other chronic medications were maintained at the same dosage and frequency. All laboratory work remained stable. After 36 hours, the patient developed sensorineural hearing loss. Erythromycin was stopped immediately. After 24 hours, there was subjective improvement of hearing, with complete return to pretreatment levels in 72 hours. Discussion: A review of the literature showed only 40 reported cases of reversible ototoxicity, mainly with high dosages of erythromycin (4 g/d). Conclusions: High-dose erythromycin therapy can cause reversible sensorineural hearing impairment. Treatment with erythromycin 4 g/d should be reserved for immunosuppressed patients with Legionnaires' disease and patients with Legionella endocarditis. Patients should have a baseline audiogram and regular monitoring for subjective evidence of sensorineural hearing loss, and the drug should be discontinued if ototoxicity is suspected.

Hypertrophic Pachymeningitis of the Internal Auditory Canal: A Rare Case of Unilateral Sudden Sensorineural Hearing Loss

2018 ◽  
Vol 127 (9) ◽  
pp. 649-652 ◽  
Author(s):  
Thomas Muelleman ◽  
Hannah Kavookjian ◽  
James Lin ◽  
Hinrich Staecker
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Internal Auditory Canal ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
High Dose ◽  
Hypertrophic Pachymeningitis ◽  
Eighth Cranial Nerve ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri

Objectives: To describe and increase awareness of a rare cause of unilateral sudden sensorineural hearing loss. Methods: Case report and literature review. Results: We present a 66-year-old female who suffered left-sided sudden sensorineural hearing loss and dizziness. Diagnostic magnetic resonance imaging (MRI) did not reveal masses or lesions along the eighth cranial nerve or in the inner ear. Upon eventual referral to neurotology clinic, hypertrophic pachymeningitis of her left internal auditory canal and adjacent middle and posterior fossa dura were identified. The ensuing laboratory workup for autoimmune and infectious etiology revealed mild elevation of ACE 93 (9-67) but otherwise normal results. Conclusions: Idiopathic hypertrophic pachymeningitis is a diagnosis of exclusion. Neoplastic, infectious, and autoimmune causes must be ruled out. The prevailing treatment for this condition is high-dose corticosteroids. This entity should be considered when evaluating MRI scans obtained in the setting of sudden sensorineural hearing loss.

scholarly journals Bilateral Sudden Sensorineural Hearing Loss Associated with Sepsis: A Case Report and Literature Review

2021 ◽  
Vol 64 (9) ◽  
pp. 674-679
Author(s):  
Hyun-Jin Lee ◽  
Seong Ki Ahn ◽  
Chae Dong Yim ◽  
Dong Gu Hur
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Systemic Disease ◽  
Vital Signs ◽  
Detailed Examination ◽  
Acute Onset ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Electrolyte Imbalance ◽  
High Dose

Bilateral sudden sensorineural hearing loss (SSNHL) is rare and usually indicates a serious systemic pathology. We describe an unusual case of bilateral SSNHL caused by sepsis. A 28-year-old female complained of acute-onset bilateral hearing impairment; in addition to otological symptoms, she had a systemic condition that met the criteria for sepsis. We performed a physical examination and laboratory tests to diagnose sepsis. Pure tone audiogram and videonystagmography were performed to evaluate the otological symptoms. Intravenous antibiotics and high-dose methylprednisolone were prescribed for treatment, and audiogram was repeated during that period. The fever subsided and the vital signs were stabilized. The electrolyte imbalance and abnormal urine parameters became normal. Hearing gradually recovered to a normal level on day 7 of hospitalization. In conclusion, sepsis should be considered as a cause of SSNHL. When conducting a detailed examination of patients with bilateral SSNHL, the clinician should consider systemic disease.

scholarly journals The Successful Use of Infliximab in a Relapsing Case of Susac’s Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Suran L. Fernando ◽  
Therese Boyle ◽  
Annika Smith ◽  
John D.E. Parratt
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Early Recognition ◽  
Delayed Diagnosis ◽  
Sensorineural Hearing ◽  
High Dose ◽  
Susac’S Syndrome ◽  
First Case ◽  
Retinal Artery ◽  
Bilateral Sensorineural Hearing Loss

Susac’s syndrome is a rare and debilitating disease characterized by the triad of encephalopathy, branch retinal artery occlusions, and sensorineural hearing loss. All manifestations may not be clinically apparent at presentation resulting in delayed diagnosis. Early recognition of the syndrome may prevent disease sequelae such as permanent cognitive, visual, and hearing loss. We present such a case of Susac’s syndrome that was also refractory to conventionally prescribed combination of immunosuppressive treatments including high-dose potent corticosteroids, intravenous cyclophosphamide, methotrexate, plasma exchange, rituximab, and mycophenolate. His disease was stabilized with infliximab in combination with a tapering course of low-dose prednisone. After 2 years of remission with TNF treatment, consideration is being given to ceasing therapy. He has the sequelae of bilateral sensorineural hearing loss but no visual impairment or cognitive deficits on follow-up with neuropsychometric testing. This is the first case report to our knowledge of the successful use of infliximab for a patient with Susac’s syndrome that was necessary following treatment with cyclophosphamide and then rituximab.

Case of neuromyelitis optica: bilateral sensorineural hearing loss and transverse myelopathy following intrathecal chemotherapy

2020 ◽  
Vol 13 (4) ◽  
pp. e234076 ◽  
Author(s):  
Sergio A Castillo-Torres ◽  
Carlos A Soto-Rincón ◽  
Héctor J Villarreal-Montemayor ◽  
Beatriz Chávez-Luévanos
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Transverse Myelitis ◽  
Intrathecal Chemotherapy ◽  
Sensorineural Hearing ◽  
Intrathecal Methotrexate ◽  
High Dose ◽  
Chemotherapeutic Drugs ◽  
Acute Transverse Myelitis ◽  
Bilateral Sensorineural Hearing Loss

Neurotoxicity from intrathecally administered chemotherapeutic drugs is frequent, particularly with some agents like methotrexate, which are more prone to developing adverse effects. Myelopathy ranks among the most frequently reported neurological entities; with the diagnosis being straightforward, after ruling out infectious, metabolic, autoimmune or paraneoplastic causes. Scarcity of cases precludes evidence-based recommendations for the management of these complications. The most common therapeutic approach consists of the suspension of chemotherapy, exclusion of infectious and neoplastic causes, with prompt administration of high-dose steroids. We report a 21-year-old patient with acute lymphoblastic leukaemia, who developed acute transverse myelitis and bilateral sensorineural hearing loss, after five rounds of intrathecal methotrexate and cytarabine. Although neurotoxicity from both agents has been documented, this combination has not been previously reported.

Intratympanic Dexamethasone after High-Dose Intravenous Methylprednisolone in Idiopathic Sudden Sensorineural Hearing Loss

2014 ◽  
Vol 151 (1_suppl) ◽  
pp. P88-P88
Author(s):  
Elizabeth A. Espitia ◽  
Estefanía Hernández-García ◽  
Monica Hernando ◽  
Ramón González-Herranz ◽  
Guillermo Plaza
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
High Dose ◽  
Intravenous Methylprednisolone ◽  
Intratympanic Dexamethasone
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