Advantage of screening for for infection in suddden and progressive hearing loss

OBJECTIVE: The aim of this retrospective study was to assess the advantage of systematic screening for infection in patients presenting with sudden or progressive sensorineural hearing loss. METHOD: 175 patients were included. 102 patients presented with unilateral sudden sensorineural hearing loss and 73 with progressive sensorineural hearing loss. Serologies tested were herpes simplex and zoster (IgM and IgG titres), Lyme disease (ELISA), syphilis (FTA-abs and MHA-TP) and HIV. RESULTS: Screening for infection was negative in 172 patients. 2 patients had positive serology for Lyme disease and one for syphilis. The case of serological syphilis was finally diagnosed as latent syphilis after ruling out neurosyphilis. Both cases of suspected Lyme disease were later invalidated by Western blot and lumbar puncture (2 false positives). CONCLUSION: Screening for infection was positive only in 1/175 patients (0.6%), rendering diagnosis of latent syphilis possible. These results suggest that, on grounds of cost-effectiveness, testing for infection should be limited to and focused on patients with a positive clinical evaluation.