Congenital Syphilitic Labyrinthitis

The finding in the aqueous humor of living spirochetes, morphologically indistinguishable fromTreponema pallidum, led to the conclusion that such microorganisms may be present in inner ear fluids in patients with deafness due to congenital syphilis. The fact that these spirochetes were eliminated by ampicillin but not penicillin suggested the use of ampicillin in these deaf patients. Assay of the concentration of ampicillin in perilymph was carried out in both cats and humans and found to be present at levels about that required for immobilization ofT pallidum. Hearing improvements were found in three patients with congenital syphilitic labyrinthitis using ampicillin, initially alone and later in combination with prednisone.