Sudden onset unilateral sensorineural hearing loss after rabies vaccination.
Sudden onset unilateral sensorineural hearing loss after rabies vaccination.
复制标题
DOI：
10.1136/bcr-2015-211977
复制
发表时间：
2015-12-15
期刊：
影响因子：
0.9
通讯作者：
Narula, Antony
中科院分区：
文献类型：
--
作者：
Okhovat, Saleh;Fox, Richard;Narula, Antony
一名33岁的男性在旅行前接种狂犬病疫苗后24小时内发生了严重的突发性右侧听力损失伴耳鸣和眩晕。无上呼吸道感染、全身性疾病、耳毒性药物或创伤病史，耳镜检查正常。纯音听力图（PTA）显示右侧感音神经性听力损失（阈值90-100 dB）和正常的左侧听力。MRI内耳道、病毒血清学（B、C、HIV和巨细胞病毒）和梅毒筛查均正常。EB病毒IgG、病毒衣壳IgG和抗耳蜗抗体（抗HSP-70）均阳性。最初的治疗包括一个疗程的高剂量口服泼尼松龙和阿昔洛韦。治疗12天后重复PTA显示听力阈值略有改善。尝试了补救性鼓室内类固醇注射，但未能进一步改善听力。突发性感音神经性听力损失（SSNHL）是一种罕见但令人恐惧的患者经历。这是首次报告的SSNHL后狂犬病免疫接种的成人。
A 33-year-old man developed profound sudden onset right-sided hearing loss with tinnitus and vertigo, within 24 h of pretravel rabies vaccination. There was no history of upper respiratory tract infection, systemic illness, ototoxic medication or trauma, and normal otoscopic examination. Pure tone audiograms (PTA) demonstrated right-sided sensorineural hearing loss (thresholds 90-100 dB) and normal left-sided hearing. MRI internal acoustic meatus, viral serology (hepatitis B, C, HIV and cytomegalovirus) and syphilis screen were normal. Positive Epstein-Barr virus IgG, viral capsid IgG and anticochlear antibodies (anti-HSP-70) were noted. Initial treatment involved a course of high-dose oral prednisolone and acyclovir. Repeat PTAs after 12 days of treatment showed a small improvement in hearing thresholds. Salvage intratympanic steroid injections were attempted but failed to improve hearing further. Sudden onset sensorineural hearing loss (SSNHL) is an uncommon but frightening experience for patients. This is the first report of SSNHL following rabies immunisation in an adult.