A CASE STUDY OF HEARING LOSS IN PRIMARY CARE

Hearing loss is a common condition in primary care. A good history and physical exams are keys for right treatment. Interviews and clinical file consulting Male patient, 75 years old, presented in programmed appointment with his wife. He has a pain poorly characterized, with no more symptoms. Meanwhile, his wife refer that probably he has Alzheimer’s disease: she refer that he has memory loss for recent events, changes in mood, withdrawal in social events and confusion in passage of time. During the anamnesis the subject remains in silence and, when interrogate, he ask to repeat questions several times. A described life history was made. There was reference to a loud sound exposure and a follow-up in Otorhinolaryngology 10 years ago without any feedback or conclusions about that appointment. The Mini Mental State was executed (28/30 score), with lost in the score acquired in Registration and Recall. Examination revealed a normal otoscopy, positive Rinne test and no lateralization in Weber test. However, there was a reduced hearing by the patient. There was a high suspicion of sensorineural hearing loss as diagnose. Without complementary exams to confirm the diagnosis, patient was referenced to otorhinolaryngology to reference hospital. This case aware for the importance of a good anamnesis allied to a decent physical examination to avoid misdiagnoses. Although his relatives thought that there was something similar to signs found in other common disease (and largely advertise in social media), there is always necessary discuss and manage this kind of mistakes in appointments.