[Pathophysiologically complex bilateral profound sensorineural hearing loss in the setting of type 2 diabetes mellitus and fungal sepsis: a case report].

Objective

This article reports a case of a 29-year-old male with type 2 diabetes mellitus complicated by fungal sepsis, resulting in bilateral profound sudden sensorineural hearing loss （SSNHL）. A literature review was conducted to summarize the clinical features, pathogenesis, and management strategies of this condition. The patient initially presented with bilateral hearing loss, accompanied by tinnitus and aural fullness in the right ear. Audiological examination revealed bilateral profound sensorineural hearing loss, with tympanometry indicating bilateral Eustachian tube dysfunction and auditory brainstem response （ABR） testing showing severe bilateral hearing impairment. Laboratory findings included elevated white blood cell count, inflammatory markers, and fungal D-glucan levels, with blood and urine cultures positive for Candida albicans. The Widal test suggested Salmonella paratyphi C infection. The patient was diagnosed with bilateral sudden sensorineural hearing loss, type 2 diabetes mellitus, sepsis （candidemia complicated by Salmonella paratyphi A and a urinary tract infection）, and acute renal failure. Treatment involved anti-infectives, renal support, blood purification, glycemic control, and corticosteroids. While the patient's overall condition improved, his hearing did not recover. This case highlights the critical role of assessing the overall systemic condition in the management of SSNHL. Sepsis, especially fungal sepsis, may serve as a significant trigger or complication of SSNHL.