Abstract
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 vesicle formation, and peripheral facial paralysis. In this syndrome, vesicles usually appear in the ipsilateral ear and/or soft palate. Some case reports of immunocompromised hosts with Hunt syndrome and generalized herpes zoster have been published.
We report the case of a 45-year-old man who developed otalgia, ear fullness, facial paralysis, pharyngitis, and generalized herpes zoster. These symptoms appeared in tandem. The characteristic generalized skin rash enabled early diagnosis. His medical history was not significant and a childhood history of varicella infection. The HIV screening test yielded negative results. The patient was diagnosed 13 days after he first visited our clinic and therapy with valacyclovir and prednisolone po was immediately initiated after diagnosis. Facial paralysis was detected on day 14 and completely resolved on day 27. The sensorineural hearing loss was partially remitted, but he was asymptomatic. The symptoms in Hunt syndrome do not always present at the onset and atypical cases like the one discussed in this report are not uncommon; therefore, this syndrome can be misdiagnosed and the patient may develop permanent facial paralysis. Therefore, it is important that otolaryngologists must have sufficient knowledge about infections caused by herpes group viruses, especially about skin rashes that appear in such cases.
