Lyme Borreliosis Associated with Sensorineural Hearing Loss: A Case Report

Background: Lyme borreliosis is a tick-borne infection caused by Borrelia species. It has a geographic distribution that makes it more frequent in certain regions like like North America and Europe. It manifests in a wide range of symptoms but is often under-investigated in patients presenting with sensorineural hearing loss (SNHL). Case Report: In this report, we describe a case presenting with SNHL as a manifestation of neuroborreliosis in a female adult patient suffering from Lyme disease, with multiple metachronous symptoms, including arthritis and seizures. Lyme borreliosis (LB) was clinically diagnosed and supported by positive serologic tests, along with Babesiosis. The patient was treated with intravenous (IV) ceftriaxone and azithromycin, in addition to oral atovaquone. Improvement after 4 weeks of IV ceftriaxone was noted in all aspects, including SNHL and arthritis. Conclusion: LB is a possible, but rare, etiology of hearing impairment. It has been documented that if treatment is initiated early, improvement and even complete recovery are possible. Hence, in a patient presenting with SNHL and a high index of suspicion for LB, assessment for LB is warranted.