A rare case report of bilateral vestibulopathy due to otosyphilis

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. A 39-year-old male was referred to our medical center due to vertigo, persistent dizziness and gait disturbance for 2 months. Bilateral vestibulopathy due to otosyphilis was considered in this case, as confirmed through analyses of vestibular function, laboratory tests, and penicillin treatment. The patient was was treated with a high dose of penicillin G (24 × 106 IU/d) for 14 days. The patient's symptoms had improved greatly following treatment, with dizziness and gait disturbance having completely resolved at 3 months following hospital discharge. 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.