Sudden sensorineural hearing loss associated with herpes simplex virus type 1 infection

Abstract

Sudden sensorineural hearing loss is a striking clinical entity often of unclear etiology. Viral infections have been implicated in the pathogenesis of this condition, especially acute or reactivated herpes simplex virus type 1 (HSV-1) infection.1,2⇓ We present a case of sudden bilateral sensorineural hearing loss associated with HSV-1-induced auditory nerve inflammation demonstrated by MRI and CSF examination. A previously healthy 61-year-old woman developed pyelonephritis. She was admitted to another hospital and experienced a myocardial infarction on her second inpatient day. Two days later, she developed herpes febrilis bilaterally around her lips, for which she was treated with acyclovir (400 mg five times per day by mouth and topically). Concurrently, she noticed sudden hearing loss that progressed to total deafness over the next 2 days. She had never had herpes febrilis before. Culture of a 3-mm punch biopsy of the labial lesions yielded HSV-1. Upon transfer to our institution 7 days after the onset of the deafness, she was totally deaf and had crusted bilateral perioral lesions. She …