Ramsay Hunt Syndrome Revealing HIV Conditions

Abstract

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.