A 25 year old male presented with a chief complaint of left ear pain that has lasted for the past 24 hours. Today, however, he reports that the pain is significantly more intense and that his ear is now red and swollen. He also states that he has vomited twice today and he feels dizzy. He describes the dizziness as a feeling that the room is spinning, and it is made worse with any movement of his head. In addition, the patient states that his hearing in his left ear is muffled compared with that in his right ear. He denies experiencing any fever, chills, headache, or generalized weakness. Give your opinion on the case please.

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Early stage of Herpes Zoster. It is better to start antiviral as early as possible. Tab Acivir 800mg 6 hourly for 7days days along with chymoral forte and Tramodol + paracetamol combination. Also start Betahistine 16mg BD for vertigo

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Herpes Zoster Oticus. Initially starts with pain. May develop Lower motor neuron facial palsy later. there may be SNHL too. diagnosis is essentially clinical , no investigations are needed. Start - Acyclovir and Prednisolone. Very useful if started within 3 days of onset of pain. early treatment will also reduce the post-herpetic neuralgia..

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Possible herpetic oticus. May develop facial palsy also. Rule out sensorineural hearing loss. May need to start on antivirals and stetoids, to recover hearing loss

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Herpes zoster oticus Tmt. Tab Acyclovir 1gm TDs, Prednisone 20mg BD, Chymoral forte + PCM +Tramadol for pain relief & Beta histidine 16mg BD for at least 7 days.

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Herpes zoster...

At present, looks like otitis externa but mostly he will develop Herpes zoster of L ear At present analgesics , anti inflammatory, anti biotic But as soon as vesicles appear, tab. Acyclovir 8oo mg 5times daily x 7 to 10 days Tab. Prednisolone 40 mg 1od morning x7 days & then gradually tapering.

Herpes zoster -. Cranial nerves ( c2 c3 ) Valciclovir- 1 gm this Dd- contact dermatitis - irritant .. . - ear dr

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Herpetic oticus Vs contact dermatitis (immunocompromised state)

Herpes zoster . Start Tab Valcivir 1g TDS

Chondritis extending to introduce ear

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