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Ramsay Hunt syndrome presenting as simple otitis externa

Published online by Cambridge University Press:  21 May 2015

Daniel Kim  and
Munsif Bhimani
Daniel Kim*
Affiliation:
Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ont.; Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ont.
Munsif Bhimani
Affiliation:
Department of Emergency Medicine, London Health Sciences Centre and Division of Emergency Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ont.
*
1912-633 Bay St., Toronto ON M5G 2G4; [email protected]

Abstract

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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.

Keywords

Ramsay Hunt syndromevaricella zoster virusherpes zoster
Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 10 , Issue 3 , May 2008 , pp. 247 - 250
Copyright
Copyright © Canadian Association of Emergency Physicians 2008

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