Hearing Loss as an Initial Symptom of Meningococcal Meningitis

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Abstract
Hearing loss is a well-known complication of meningococcal meningitis and is commonly bilateral, severe, and permanent.1·2 A review of the literature revealed only three previously reported cases of meningitis with deafness at onset.34 We describe a patient whose initial symptom was bilateral deafness, in whom signs of meningitis became obvious only later. REPORT OF A CASE A 20-year-old man was examined because of neck pain immediately following local trauma at work that day. Results of physical examination were unremarkable. The patient was afebrile, without meningitic signs. Roentgenograms of the cervical spine were normal, and he was sent home. The next day, the patient complained of continued neck pain, sore throat, and decreased hearing. He said he had no headache. His pharynx appeared inflamed, but he was afebrile and had no other significant physical findings. The patient was treated with a single dose of parenteral penicillin G sodium, followed

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