To investigate the clinical characteristics and outcome of neurobrucellosis patients with hearing loss as the major clinical manifestation.

From October 2008 to September 2019, 7 cases of neurobrucellosis with hearing loss in Beijing Ditan hospital, Capital Medical University were selected, and their clinical data including epidemiological history, clinical manifestations, etiological specificity, cerebrospinal fluid analysis, ear examination, pure tone audiometry, imaging findings were analyzed, respectively. Analysis and discussion were performed based on domestic and foreign literature.

Among the 7 neurobrucellosis patients with hearing loss, 5 were male and 2 were female, aged 22-70 years old, with the average age as 39.29 years old. All of the 7 patients had definite epidemiological history, early presentation of typical symptoms of brucellosis: fever, hyperhidrosis, muscle and joint pain, fatigue and headache, etc. Hearing loss was manifested as sensorineural deafness, 2 cases in the early stage, 3 cases in the course of treatment and 2 cases after drug withdrawal. There were 2 cases with unilateral hearing loss and 5 cases with binaural diseases. There were 2 cases with sudden deafness and 5 cases with progressive hearing loss. There were 4 cases with the course of hearing loss < 3 months, whose hearing capabilities were all improved after treatment; there were 3 cases with the course of hearing loss > 3 months but no case occured hearing improvement after treatment. There were 5 cases with mild and moderate deafness, 2 cases with severe and extremely severe deafness. Lumbar puncture showed a slight increase in intracranial pressure, with an average of 197 mmH₂O, elevated white blood cells in cerebrospinal fluid, with an average of 104 cells/μl [monocytes dominated (90.7%)], cerebrospinal fluid protein as 206.1 mg/dl, cerebrospinal fluid sugar as 1.95 mmol/L, cerebrospinal fluid chloride as 118.7 mmol/L.

Hearing loss associated with neurobrucellosis was not rare. Because of its relatively lack of specific clinical manifestations, it was easy to misdiagnose and missed diagnosis. Early detection, diagnosis and treatment could decrease sequelae.