Surdez súbita: o que nos escapa? Surdez como única apresentação de Doença de Lyme

Introduction: Lyme´s disease is a systemic infection and the most common thick-borne disease in North America, Europe and Asia. Described for the first time in 1977 in the US and in 1989 in Portugal, it became a notifiable disease in 1999. Lisbon district is the most affected area, with an annual incidence of 0,04/100000 habitants. Objective: To present the clinical case of a female patient with unilateral sudden deafness as the single Lyme´s disease manifestation. Material and methods: A 40 yo female patient complaining of a right sudden deafness with 48h of evolution. All anamnesis evaluation was normal. She has been medicated immediately with steroids, antiretrovirals and hyperbaric oxygen and a laboratorial and imagiological investigation began. Results: Partial recovery was noticed after 10 hyperbaric therapeutic sessions. Laboratory evaluation confirmed Borrelia Burgdorferi IgM antibodies and the MRI scan showed a right labyrinthitis. She started doxycycline and she totally recovered from deafness. Borrelia serology became negative and the imagiological signs of labyrinthitis were absent 5 months after the diagnosis. Conclusion: Sudden deafness can be the only Lyme´s disease manifestation, despite being usually a systemic disease. Specific diagnosis and therapy avoided some of the serious complications of the disease, neurological for instance. Therefore it is important to go through detailed diagnostic tests in sudden deafness cases, in order to diagnose and treat possible curable causes.