First described in 1907 by James Ramsay Hunt, Ramsay Hunt syndrome is a recurrence (reactivation) of varicella-zoster virus (VZV) affecting the geniculate ganglion, secondary to a decrease in cell-mediated immunity. T...First described in 1907 by James Ramsay Hunt, Ramsay Hunt syndrome is a recurrence (reactivation) of varicella-zoster virus (VZV) affecting the geniculate ganglion, secondary to a decrease in cell-mediated immunity. The strict definition of Ramsay Hunt syndrome is peripheral facial nerve palsy accompanied by erythematous vesicular rash on the ear. We report a 57-year-old female immunocompetent patient complaining of otalgia, small vesicles on the Ramsey Hunt Zone. She does not complain fever, hearing loss, nausea, vomiting or dizziness. There was no peripheral facial nerve palsy, no reduction of taste sensation, no ataxia or nystagmus, Romberg sign was negative. Our patient targets two of the three criteria needed for the diagnosis of Ramsay Hunt syndrome. She began to take Acyclovir-Steroid (AS) therapy very early with good outcome. This suggests that prompt diagnosis and management improve outcome and prevent occurrence of nerve palsy in Ramsay Hunt syndrome.展开更多
Objective: To discuss the diagnostic, therapeutic, and evolutionary aspects of a case of herpes zoster oticus associated with facial palsy in HIV conditions. Case Study: We report the case of a 32-year-old married fem...Objective: To discuss the diagnostic, therapeutic, and evolutionary aspects of a case of herpes zoster oticus associated with facial palsy in HIV conditions. Case Study: We report the case of a 32-year-old married female beautician patient admitted with severe right otalgia associated with a fever that had been evolving for three days. The addition of homolateral otorrhea and headache was noted. The initial examination on admission noted a vesicular rash of the pinna and the external third of the right external auditory canal with a normal tympanic membrane. The evolution was marked 48 hours later by the appearance of a right facial palsy grade V. The CT scan of the rock showed a mastoid and maxillary sinus hypodensity. The paraclinical exploration found a positive retroviral serology to HIV 1 and 2. The diagnosis retained was a Ramsay Hunt syndrome on HIV condition associated with ipsilateral maxillary sinusitis and mastoiditis. The treatment administered was a combination of amoxicillin/clavulanic acid injection of 3 g per day + oral aciclovir 200 mg, acetaminophen 1 g injectable every 6 h, betamethasone 4mg per day, vitamin B complex, artificial tear. Therapeutic inclusion in the HIV/AIDS national program was performed. The evolution was marked by the total regression of the facial palsy after six months of treatment. Conclusion: Otogenic diseases in HIV remain a problem in our context where the circumstances of discovery are most often fortuitous, hence the need to search for the serological status in front of any suspicion of viral infection in adults. The status may constitute a triggering factor or a factor of the severity of the pathology or of the symptoms such as facial palsy or deafness in our case. Early and adapted management has been shown to improve the prognosis.展开更多
文摘First described in 1907 by James Ramsay Hunt, Ramsay Hunt syndrome is a recurrence (reactivation) of varicella-zoster virus (VZV) affecting the geniculate ganglion, secondary to a decrease in cell-mediated immunity. The strict definition of Ramsay Hunt syndrome is peripheral facial nerve palsy accompanied by erythematous vesicular rash on the ear. We report a 57-year-old female immunocompetent patient complaining of otalgia, small vesicles on the Ramsey Hunt Zone. She does not complain fever, hearing loss, nausea, vomiting or dizziness. There was no peripheral facial nerve palsy, no reduction of taste sensation, no ataxia or nystagmus, Romberg sign was negative. Our patient targets two of the three criteria needed for the diagnosis of Ramsay Hunt syndrome. She began to take Acyclovir-Steroid (AS) therapy very early with good outcome. This suggests that prompt diagnosis and management improve outcome and prevent occurrence of nerve palsy in Ramsay Hunt syndrome.
文摘Objective: To discuss the diagnostic, therapeutic, and evolutionary aspects of a case of herpes zoster oticus associated with facial palsy in HIV conditions. Case Study: We report the case of a 32-year-old married female beautician patient admitted with severe right otalgia associated with a fever that had been evolving for three days. The addition of homolateral otorrhea and headache was noted. The initial examination on admission noted a vesicular rash of the pinna and the external third of the right external auditory canal with a normal tympanic membrane. The evolution was marked 48 hours later by the appearance of a right facial palsy grade V. The CT scan of the rock showed a mastoid and maxillary sinus hypodensity. The paraclinical exploration found a positive retroviral serology to HIV 1 and 2. The diagnosis retained was a Ramsay Hunt syndrome on HIV condition associated with ipsilateral maxillary sinusitis and mastoiditis. The treatment administered was a combination of amoxicillin/clavulanic acid injection of 3 g per day + oral aciclovir 200 mg, acetaminophen 1 g injectable every 6 h, betamethasone 4mg per day, vitamin B complex, artificial tear. Therapeutic inclusion in the HIV/AIDS national program was performed. The evolution was marked by the total regression of the facial palsy after six months of treatment. Conclusion: Otogenic diseases in HIV remain a problem in our context where the circumstances of discovery are most often fortuitous, hence the need to search for the serological status in front of any suspicion of viral infection in adults. The status may constitute a triggering factor or a factor of the severity of the pathology or of the symptoms such as facial palsy or deafness in our case. Early and adapted management has been shown to improve the prognosis.
