• Huanhuan Gu, Yixin Xu, Jin Xu, and Jianhua Zhuang.
• Department of Neurology, Second Affiliated Hospital of Naval Medical University, Shanghai, Huangpu District, Shanghai, China.
• Medicine (Baltimore). 2024 May 17; 103 (20): e38149e38149.

RationaleBilateral 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 ConcernsA 39-year-old male was referred to our medical center due to vertigo, persistent dizziness and gait disturbance for 2 months.DiagnosesBilateral vestibulopathy due to otosyphilis was considered in this case, as confirmed through analyses of vestibular function, laboratory tests, and penicillin treatment.InterventionsThe patient was was treated with a high dose of penicillin G (24 × 106 IU/d) for 14 days.OutcomesThe patient's symptoms had improved greatly following treatment, with dizziness and gait disturbance having completely resolved at 3 months following hospital discharge.LessonsBilateral 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.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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