Mediterranean spotted fever is an infection disease caused by Rickettsiae and transmitted by tick puncture; the diffusion of such disease is wide in countryside of the Mediterranean regions. The disease may be complicated by several organ failure due to a vasculitis, and also the inner ear can be involved although rarely. We report the first documented case of total involvement of inner ear with sensorineural hearing loss and acute vestibular impairment. The patient was treated with medical

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... apy and resolution of the infection, but the inner ear damage was not reversible with persistent loss of all functions, documented by instrumental vestibular analysis.