A rare case report of bilateral vestibulopathy due to otosyphilis

Rationale:Bilateral vestibulopathy is an important cause of imbalance. There are multiple etiologies of bilateral vestibulopathy (BVP), but reports of BVP due to otosyphilis are rare.Patient concerns:A 39-year-old male was referred to our medical center due to vertigo, persistent dizziness and gait disturbance for 2 months.Diagnoses:Bilateral vestibulopathy due to otosyphilis was considered in this case, as confirmed through analyses of vestibular function, laboratory tests, and penicillin treatment.Interventions:The patient was was treated with a high dose of penicillin G (24 x 106 IU/d) for 14 days.Outcomes:The patient's symptoms had improved greatly following treatment, with dizziness and gait disturbance having completely resolved at 3 months following hospital discharge.Lessons:Bilateral vestibulopathy should be considered when evaluating patients with acute or subacute persistent dizziness. Clinicians should also be aware of the potential for otosyphilis among patients who report BVP.