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Syphilitic otitis media
Last reviewed: 07.07.2025
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Ear infection with syphilis, or syphilitic otitis, can be observed at all stages of this venereal disease.
Symptoms of syphilitic otitis
Primary syphilis, manifested by chancre, is very rare and occurs as a result of accidental infection of the auricle or external auditory canal when the skin is damaged or when kissing. Primary chancre is usually accompanied by regional specific lymphadenitis, a feature of which is painlessness of enlarged and pasty lymph nodes.
Secondary syphilis of the auricle and periauricular area manifests itself as syphilitic papules, and in the external auditory canal - as syphilitic condylomas. In the middle ear, this stage of the disease manifests itself as subacute catarrhal otitis, no different from banal otitis. The diagnosis is established only on the basis of the ineffectiveness of conventional treatment. The mastoid process is involved in the process, characterized by periostitis and regional lymphadenitis, while a normal otoscopic picture is observed and the hearing function is not impaired. The final diagnosis at this stage is established using serodiagnosis. At this stage, lesions of the inner ear and auditory nerve can be observed.
Tertiary syphilis may manifest itself as a gummatous process in both the outer and middle ear and the mastoid process. A characteristic feature of the resulting tumor-like formations is their painlessness and the absence of any trauma in the anamnesis. At this stage, signs of damage to the inner ear are also observed. Trial antisyphilitic treatment for syphilitic infection causes the Herxheimer reaction, caused by the death of spirochetes and the release of endotoxin, which affects the receptors of the inner ear (total deafness and switching off of the vestibular apparatus).
Congenital syphilis of the ear is observed in 20% of cases of this type of syphilis. In early age, dysgenesis of the UR and NSP are observed, as well as bilateral deafness leading to surdomutism. In adulthood, congenital syphilis of the ear can manifest itself as syphilitic neurolabyrinitis.
Where does it hurt?
Fusospirillosis otitis media
Fusospirillosis otitis media is a type of necrotic otitis. Its pathogens are spindle-shaped bacillus and spirochete. The onset of the disease is imperceptible, the clinical course is persistent with frequent relapses and destructive consequences.
Purulent discharges are putrefactive, foul-smelling, with an admixture of blood. The absorption of putrefactive decay products, their penetration through the windows of the labyrinth leads to early sensorineural hearing loss, the destruction of the sound-conducting system - to conductive hearing loss.
The treatment is long-term. Arsenic, iodine, etc. preparations are used.
What do need to examine?
How to examine?
What tests are needed?
Treatment of syphilitic otitis
Treatment of syphilitic otitis is generally accepted for syphilitic infection.