BACKGROUND Brucellosis is one of the most common zoonotic infectious diseases in the world,with approximately 500000 new cases of human brucellosis diagnosed each year.Brucellosis can simulate various multi-system dis...BACKGROUND Brucellosis is one of the most common zoonotic infectious diseases in the world,with approximately 500000 new cases of human brucellosis diagnosed each year.Brucellosis can simulate various multi-system diseases,presenting atypical symptoms.Very few brucellosis cases with pancytopenia accompanied by a severe hearing loss have been reported.In the literature review,we could find only one similar case reported in the past.Moreover,this disease is easily misdiagnosed as a blood system disease leading to delayed treatment.Thus,it is important to improve clinicians'awareness of this disease.CASE SUMMARY A 64-year-old woman presented with dizziness and fatigue,accompanied by pancytopenia and severe hearing loss.Brucella melitensis was identified on blood culture.Anti-infective therapy with rifampicin(900 mg/d)and doxycycline(100 mg twice a day)was prescribed for 4 mo along with ceftriaxone 2 g/d for 1 mo.The patient showed a good response to antibiotic therapy.Her blood counts returned to normal followed by significant improvement in hearing.CONCLUSION Brucellosis should be considered in the differential diagnosis of patients presenting with pancytopenia and hearing loss.展开更多
Background:The prevalence of sudden sensorineural hearing loss in children(CSSNHL)is consistently increasing.However,the pathology and prognosis of CSSNHL are still poorly understood.This retrospective study evaluated...Background:The prevalence of sudden sensorineural hearing loss in children(CSSNHL)is consistently increasing.However,the pathology and prognosis of CSSNHL are still poorly understood.This retrospective study evaluated clinical characteristics and possible associated factors of CSSNHL.Methods:One hundred and thirty-six CSSNHL patients treated in Department of Otolaryngology-Head and Neck Surgery and Institute of Otolaryngology at Chinese PLA General Hospital between July 2008 and August 2015 were included in this study.These patients were analyzed for clinical characteristics,audiological characteristics,laboratory examinations,and prognostic factors.Results:Among the 136 patients(151 ears),121 patients(121 ears,80.1%)were diagnosed with unilaterally CSSNHL,and 15 patients(30 ears,19.9%)with bilateral CSSNHL.The complete recovery rate of CSSNHL was 9.3%,and the overall recovery rate was 37.7%.We found that initial degree of hearing loss,onset of treatment,tinnitus,the ascending type audiogram,gender,side of hearing loss,the recorded auditory brainstem response(ABR),and distortion product otoacoustic emissions(DPOAEs)had prognostic significance.Age,ear fullness,and vertigo had no significant correlation with recovery.Furthermore,the relevant blood tests showed 30.8%of the children had abnormal white blood cell(WBC)counts,22.1%had elevated homocysteine levels,65.8%had high alkaline phosphatase(ALP),33.8%had high IgE antibody levels,and 86.1%had positive cytomegalovirus(CMV)IgG antibodies.Conclusions:CSSNHL commonly occurs unilaterally and results in severe hearing loss.Initial severe hearing loss and bilateral hearing loss are negative prognostic factors for hearing recovery,while positive prognostic factors include tinnitus,gender,the ascending type audiogram,early treatment,identifiable ABR waves,and DPOAEs.Age,vertigo,and ear fullness are not correlated with the recovery.Some serologic indicators,including the level of WBC,platelet,homocysteine,ALP,positive CMV IgG antibody,fibrinogen,and some immunologic indicators,are closely related to CSSNHL.展开更多
文摘BACKGROUND Brucellosis is one of the most common zoonotic infectious diseases in the world,with approximately 500000 new cases of human brucellosis diagnosed each year.Brucellosis can simulate various multi-system diseases,presenting atypical symptoms.Very few brucellosis cases with pancytopenia accompanied by a severe hearing loss have been reported.In the literature review,we could find only one similar case reported in the past.Moreover,this disease is easily misdiagnosed as a blood system disease leading to delayed treatment.Thus,it is important to improve clinicians'awareness of this disease.CASE SUMMARY A 64-year-old woman presented with dizziness and fatigue,accompanied by pancytopenia and severe hearing loss.Brucella melitensis was identified on blood culture.Anti-infective therapy with rifampicin(900 mg/d)and doxycycline(100 mg twice a day)was prescribed for 4 mo along with ceftriaxone 2 g/d for 1 mo.The patient showed a good response to antibiotic therapy.Her blood counts returned to normal followed by significant improvement in hearing.CONCLUSION Brucellosis should be considered in the differential diagnosis of patients presenting with pancytopenia and hearing loss.
基金This study was financially supported by grants from the National Key Basic Research Program of China,the National Natural Science Foundation of China
文摘Background:The prevalence of sudden sensorineural hearing loss in children(CSSNHL)is consistently increasing.However,the pathology and prognosis of CSSNHL are still poorly understood.This retrospective study evaluated clinical characteristics and possible associated factors of CSSNHL.Methods:One hundred and thirty-six CSSNHL patients treated in Department of Otolaryngology-Head and Neck Surgery and Institute of Otolaryngology at Chinese PLA General Hospital between July 2008 and August 2015 were included in this study.These patients were analyzed for clinical characteristics,audiological characteristics,laboratory examinations,and prognostic factors.Results:Among the 136 patients(151 ears),121 patients(121 ears,80.1%)were diagnosed with unilaterally CSSNHL,and 15 patients(30 ears,19.9%)with bilateral CSSNHL.The complete recovery rate of CSSNHL was 9.3%,and the overall recovery rate was 37.7%.We found that initial degree of hearing loss,onset of treatment,tinnitus,the ascending type audiogram,gender,side of hearing loss,the recorded auditory brainstem response(ABR),and distortion product otoacoustic emissions(DPOAEs)had prognostic significance.Age,ear fullness,and vertigo had no significant correlation with recovery.Furthermore,the relevant blood tests showed 30.8%of the children had abnormal white blood cell(WBC)counts,22.1%had elevated homocysteine levels,65.8%had high alkaline phosphatase(ALP),33.8%had high IgE antibody levels,and 86.1%had positive cytomegalovirus(CMV)IgG antibodies.Conclusions:CSSNHL commonly occurs unilaterally and results in severe hearing loss.Initial severe hearing loss and bilateral hearing loss are negative prognostic factors for hearing recovery,while positive prognostic factors include tinnitus,gender,the ascending type audiogram,early treatment,identifiable ABR waves,and DPOAEs.Age,vertigo,and ear fullness are not correlated with the recovery.Some serologic indicators,including the level of WBC,platelet,homocysteine,ALP,positive CMV IgG antibody,fibrinogen,and some immunologic indicators,are closely related to CSSNHL.
