Liu YC, Hsiao SH, Chen PR. Herpes simplex virus 2-induced aseptic meningitis presenting with sudden deafness: A case report. World J Clin Cases 2025; 13(8): 98320 [DOI: 10.12998/wjcc.v13.i8.98320]
Corresponding Author of This Article
Shih-Hsuan Hsiao, MD, Chief Doctor, Department of Otolaryngology, Hualien Tzu Chi Hospital, and Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Tzu Chi University, 707, Sec 3, Chung-Yang Road, Hualien 970, Taiwan. hsiao62ntuh@gmail.com
Research Domain of This Article
Otorhinolaryngology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 16, 2025; 13(8): 98320 Published online Mar 16, 2025. doi: 10.12998/wjcc.v13.i8.98320
Herpes simplex virus 2-induced aseptic meningitis presenting with sudden deafness: A case report
Yuan-Cheng Liu, Shih-Hsuan Hsiao, Peir-Rong Chen
Yuan-Cheng Liu, Peir-Rong Chen, Department of Otolaryngology, Hualien Tzu Chi Hospital, Hualien 970, Taiwan
Shih-Hsuan Hsiao, Department of Otolaryngology, Hualien Tzu Chi Hospital, and Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Tzu Chi University, Hualien 970, Taiwan
Author contributions: Hsiao SH, Chen PR designed the research study; Hsiao SH performed the research; Liu YC analyzed the data and wrote the manuscript. All authors have read and approved the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We have no conflicts of interest to disclose. All authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shih-Hsuan Hsiao, MD, Chief Doctor, Department of Otolaryngology, Hualien Tzu Chi Hospital, and Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Tzu Chi University, 707, Sec 3, Chung-Yang Road, Hualien 970, Taiwan. hsiao62ntuh@gmail.com
Received: June 24, 2024 Revised: November 3, 2024 Accepted: November 22, 2024 Published online: March 16, 2025 Processing time: 162 Days and 22.2 Hours
Abstract
BACKGROUND
Aseptic meningitis is defined as meningeal inflammation caused by various etiologies with negative cerebrospinal fluid (CSF) bacterial culture. The most common etiologies are viruses [enteroviruses, arboviruses, and herpes simplex virus type 2 (HSV-2)]. Aseptic meningitis can have various presentations, including sensorineural deafness. While sensorineural deafness from mumps meningoencephalitis has been reported, cases of HSV-2-induced hearing loss are rare. Herein, we report a case of HSV-2-induced meningitis that presented with sudden deafness.
CASE SUMMARY
A 68-year-old man experienced a profound sudden onset of left-sided hearing loss for one day. Pure-tone audiograms demonstrated sudden left-sided sensorineural hearing loss (thresholds 80-90 dB). After treatment with high-dose steroids for 1 week, he experienced an acute consciousness change with left hemiparesis. The laboratory data showed no significant abnormalities. Brain computed tomography without contrast and magnetic resonance imaging revealed no intracranial hemorrhage or obvious brain lesion. The CSF analysis and the Multiplex PCR panels showed HSV-2 positivity. Hence, under the diagnosis of herpes meningoencephalitis, acyclovir was prescribed and his symptoms gradually resolved.
CONCLUSION
This case report further demonstrates that a viral infection could be a cause of sudden sensorineural hearing loss.
Core Tip: We report a case of herpes simplex virus type 2 (HSV-2)-induced meningitis presenting with sudden deafness. A 68-year-old man experienced sudden left-sided hearing loss for one day. Pure-tone audiograms showed left-sided sensorineural hearing loss with an average threshold of 80 dB. After one week of high-dose steroids, the patient experienced acute changes in consciousness with left hemiparesis. Laboratory data showed no significant abnormalities. Brain computed tomography and magnetic resonance imaging revealed no intracranial hemorrhage or lesions. Cerebrospinal fluid analysis and multiplex PCR confirmed HSV-2. Acyclovir was prescribed for herpes meningoencephalitis, and symptoms gradually resolved.
