Abstract
Otosyphilis is a rare cause of acute sensorineural hearing loss. This report presents a case of otosyphilis causing unilateral acute sensorineural hearing loss in a 50-year-old female. The initial symptoms included left-sided hearing loss, tinnitus, headache, and nausea, which persisted despite oral steroid therapy. Blood tests revealed positive syphilis serology and cerebrospinal fluid (CSF) analysis indicated neurosyphilis. Treatment with ampicillin (AMPC) and tapered steroid therapy improved the symptoms, except for residual impairment at a frequency of 1 kHz. This case highlights the significance of considering syphilis in the differential diagnosis of acute sensorineural hearing loss, thorough history taking, serological testing, and when indicated, CSF analysis to ensure timely diagnosis and management.