{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T15:35:24Z","timestamp":1777563324313,"version":"3.51.4"},"reference-count":10,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ear Nose Throat J"],"abstract":"<jats:p>\n                    This report describes an atypical presentation of cryptococcal meningitis (CM) in a 51\u2009year-old HIV-negative male with diabetes, hypertension, and psoriasis. The patient presented with a 10\u2009day history of subacute headache, vomiting, and fever, followed by the abrupt onset of profound bilateral sensorineural hearing loss (SNHL), ataxia, diplopia, anosmia, ageusia, drowsiness, meningismus, absent gag reflex, and bilateral abducens palsy. Brain MRI revealed inflammatory changes involving the sellar diaphragm, thalamus, and pituitary stalk. Cerebrospinal fluid analysis confirmed CM (pleocytosis, elevated protein, hypoglycorrhachia, opening pressure &gt;60\u2009cmH\n                    <jats:sub>2<\/jats:sub>\n                    O, positive cryptococcal antigen), with negative HIV and malignancy screens. Audiometry confirmed profound bilateral SNHL. Treatment included intravenous liposomal amphotericin B followed by high-dose oral fluconazole, augmented by serial therapeutic lumbar punctures for intracranial pressure (ICP) control. Partial hearing recovery was observed at 1\u2009month follow-up. This case highlights that sudden bilateral SNHL\u2014rarely the dominant initial manifestation\u2014can herald CM even in hosts without overt immunosuppression, posing significant diagnostic challenges. The constellation of profound SNHL, multiple cranial neuropathies (including VIII), cerebellar signs, and markedly-elevated ICP strongly implicates retrocochlear pathology, likely resulting from meningeal inflammation, direct vestibulocochlear nerve invasion, and\/or neural compression. Critically, timely-antifungal therapy combined with aggressive ICP reduction facilitated neurological recovery, demonstrating potential reversibility and avoiding premature cochlear implantation. Clinicians should consider CM in patients presenting with acute bilateral audiovestibular dysfunction accompanied by cranial neuropathies or elevated ICP, particularly with subacute prodromal symptoms. This case underscores the essential role of concurrent ICP-directed management alongside antifungals to optimize neurological outcomes, including hearing recovery.\n                  <\/jats:p>","DOI":"10.1177\/01455613251380077","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T04:36:31Z","timestamp":1758688591000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Reversible Profound Sensorineural Hearing Loss Complicating Cryptococcal Meningitis in an Immunocompetent Adult: Diagnostic and Therapeutic Insights"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6479-8547","authenticated-orcid":false,"given":"Ahmad","family":"Alkheder","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Al-Mouwasat University Hospital, Damascus University, Syria"},{"name":"Faculty of Medicine, Damascus University, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin Ahmad","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Damascus University, Syria"},{"name":"Department of Neurology, National University Hospital, Damascus University, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaled","family":"Ziadah","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Al-Mouwasat University Hospital, Damascus University, Syria"},{"name":"Faculty of Medicine, Damascus University, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aliaa","family":"Issa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Al-Mouwasat University Hospital, Damascus University, Syria"},{"name":"Faculty of Medicine, Damascus University, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"Abbas","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Damascus University, Syria"},{"name":"Department of Neurology, National University Hospital, Damascus University, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghassan","family":"Hamzeh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Damascus University, Syria"},{"name":"Department of Neurology, National University Hospital, Damascus University, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,9,23]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1159\/000049266"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2021-242059"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2020-239040"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.4081\/idr.2015.6173"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1017\/S002221511600801X"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1808-8694(15)31055-7"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.72.851.575"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2008.08.009"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2020.10.008"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002242"}],"container-title":["Ear, Nose &amp; Throat Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01455613251380077","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/01455613251380077","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01455613251380077","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T18:39:07Z","timestamp":1777401547000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/01455613251380077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,23]]},"references-count":10,"alternative-id":["10.1177\/01455613251380077"],"URL":"https:\/\/doi.org\/10.1177\/01455613251380077","relation":{},"ISSN":["0145-5613","1942-7522"],"issn-type":[{"value":"0145-5613","type":"print"},{"value":"1942-7522","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,23]]},"article-number":"01455613251380077"}}