Ramsay Hunt syndrome (Hunt syndrome) is characterized by herpetic lesions on the face, combined with VII and VIII cranial nerve involvement. It is caused by reactivation of varicella zoster virus (VZV), and is associated with multiple cranial polyneuropathy in 1.8%–3.2% of cases.
Herein, we report the case of a patient with human immunodeficiency virus (HIV) infection who presented with Hunt syndrome associated with multiple cranial nerve involvement. The patient, a 41-year-old male patient presenting with left earache, left hearing loss and swallowing difficulty, was diagnosed by physical examination as having involvement of the VIII, IX and X cranial nerves. This was an atypical case, that had been diagnosed as having Hunt syndrome three years ago and presented this time with VZV infection associated with several cranial nerve symptoms. Therefore, he was suspected as having immunodeficiency, and a blood test revealed the patient was HIV-antibody positive. In addition, during a careful medical interview, the patient admitted to being homosexual.
The possibility that atypical Hunt syndrome may be a feature of HIV infection, especially in young homosexual men, should be borne in mind.
