A Case of Bacterial Meningoencephalitis Following Sudden Sensorineural Hearing Loss with Vertigo

Abstract

Received August 12, 2015 Revised October 9, 2015 Accepted October 18, 2015 Address for correspondence Mee Hyun Song, MD, PhD Department of OtorhinolaryngologyHead and Neck Surgery, Myongji Hospital, Seonam University College of Medicine, 55 Hwasu-ro 14beon-gil, Deogyang-gu, Goyang 10475, Korea Tel +82-31-810-6360 Fax +82-31-810-6357 E-mail meehyun924@hanmail.net We report a case of sudden sensorineural hearing loss with vertigo in a 68-year-old woman, who developed bacterial meningoencephalitis during steroid treatment. The patient initially showed severe degree of sensorineural hearing loss on the left side with spontaneous nystagmus beating toward the contralateral side. Brain magnetic resonance imaging demonstrated no abnormal finding other than high signal intensity in parts of mastoid air cells and mild mucosal hypertrophy of the paranasal sinuses. During the course of steroid treatment, the hearing worsened to profound hearing loss, and on the 6th day of steroid treatment, the patient demonstrated dysarthria and disorientation with subsequent development of high fever. The patient was diagnosed with bacterial meningoencephalitis and treated with antibiotics. The patient recovered without any neurologic deficit but unilateral profound hearing loss persisted. The case is presented here along with a possible pathogenic mechanism of bacterial meningoencephalitis following sudden sensorineural hearing loss in this patient. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(2):165-9