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 × 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.
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