Sensorineural hearing loss complicating severe rickettsial diseases: report of two cases.

Sub-acute focal neurological manifestations are reported rarely in systemic rickettsial diseases and are considered to be secondary to immune-mediated mechanisms. We present two cases of transient sensorineural hearing loss complicating the course of severe rickettsial diseases caused by Rickettsia typhi and Rickettsia conorii, respectively. The diagnosis was based on the presence of high IgM antibodies and the prompt response to doxycycline treatment. In both cases, hearing loss presented during convalescence and resolved automatically without administration of specific treatment.