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Herpes zoster oticus



Herpes zoster oticus Causes


HZ oticus is caused by the reactivation of latent VZV, which has remained dormant inside the sensory ganglia of the facial nerve. Individuals with reduced cell-mediated immunity resulting from carcinoma, radiation therapy, chemotherapy, or HIV infection are at greater risk for reactivation of latent VZV. Physical and emotional stress usually are cited as precipitating factors.


Herpes zoster oticus Definition


Herpes zoster oticus (HZ oticus) is a viral infection affecting the inner, middle, and external ear. HZ oticus manifests as severe otalgia and associated cutaneous vesicular eruption, typically of the external canal and pinna. When linked with facial paralysis, the infection is called Ramsay Hunt syndrome.


Herpes zoster oticus Diagnosis


If there is any question about viral etiology, vesicular scrapings may be collected for direct immunofluorescence or for viral cultures, and MRI is done for the patient.


Herpes zoster oticus Symptoms and Signs


Patients with herpes zoster oticus may experience hearing loss, vertigo, tinnitus, dry mouth and dry eyes, facial paralysis, and loss of taste.


Herpes zoster oticus Treatment


Some cases of HZ oticus do not require treatment. If treatment is needed, medications, antiviral drugs, corticosteroids, and diazepam (for vertigo) may prove effective. Although there is no reliable evidence that corticosteroids, antiviral drugs, or surgical decompression makes a difference, they are the only possibly effective treatments. Corticosteroids are initiated with prednisone.


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