Herpes zoster oticus

4 Interesting Facts of Herpes zoster oticus (Ramsay Hunt syndrome)

  1. Caused by reactivation of varicella-zoster virus in the cutaneous distribution of the auricle and external auditory meatus; can result in facial and vestibulocochlear neuropathy
  2. Presents similarly to otitis externa with severe otalgia; additional findings include a vesicular rash in the external ear canal, loss of taste on the anterior two-thirds of the tongue, and decreased lacrimation on the involved side 
  3. Patients may present with facial paralysis and vertigo 
  4. Differentiate diseases based on clinical presentation; if diagnosis remains in question, confirm with a positive result on Tzanck test and polymerase chain reaction to detect varicella-zoster virus DNA on skin lesion specimen

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