Ramsay Hunt syndrome presenting as simple otitis externa.
Ramsay Hunt syndrome is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus infection occurs in the geniculate ganglion, causing otalgia, auricular vesicles and peripheral facial paralysis. Because these symptoms do not always present at the onset, this syndrome can be misdiagnosed. We report the case of a patient who was diagnosed with simple otitis externa after presenting to the emergency department (ED) with a 3-day history of right-sided otalgia. Her condition subsequently evolved to include right-sided auricular vesicles and right-sided facial weakness. She presented to the ED again after 2 days and was correctly diagnosed with Ramsay Hunt syndrome. We describe the clinical presentation, diagnostic findings and management of this uncommon but important entity.
Kim
Daniel
D
Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. dkim000@gmail.com
Bhimani
Munsif
M
D000212:Acyclovir / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D003951:Diagnostic Errors; D005260:Female; D016697:Herpes Zoster Oticus / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D010032:Otitis Externa / Q000175:diagnosis
D000998:Antiviral Agents; D000212:Acyclovir