Thursday, March 22, 2012

Ear All About It!

This older patient (or unimmunized adolescent) presents with left-sided facial paralysis and ear pain. He complains that things taste and sound differently; he has a buzzing in his ear and everything's louder. He also has vertigo. Prior to the onset of the rash shown above, he noted burning pain, hyperesthesia, and pruritis.

Challenge: What's your diagnosis?

Image shown under Fair Use.

3 comments:

our.man.jonesy said...

Herpesvirus reactivation-- Though, I'm tempted to say HSV despite the lack of vaccine indicated in the hint, if only because of the likelihood of temporal lobe encephalitis.

But, if pressed, I'd say Shingles, possibly with resulting trigeminal neuralgia.

Reflex Hammer said...

Herpes zoster (again)?

Craig Chen said...

yes - it is HSV! (again - sometimes i just have to review these disease manifestations :))
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Ear All About It!

This is Ramsay Hunt syndrome or herpes zoster oticus caused by VZV reactivation.

Sources: UpToDate; emedicine.medscape.com.