Viral Ear Infection: A Growing Problem
Herpes Zoster Oticus or Auricular Herpes Zoster is a viral infection of the inner, middle and external ear. It manifests as severe ear ache and associated with fluid filled eruptions on skin, usually of external ear and pinna. When associated with facial paralysis, it is also called Ramsay Hunt Syndrome. Proper treatment of the infection can reduce your risk of complications, which can include permanent facial muscle weakness and deafness.
Herpes Zoster Oticus is caused by the reactivation of latent varicella zoster virus or chicken pox virus, which has remained dormant in geniculate ganglion of the facial nerve. It occurs in people who have had chicken pox. Once you recover from chicken pox that virus can lie dormant in your body for years and sometimes reactivate in later years causing the disease.
Individuals with decreased cell mediated immunity such as –
• Old age (more than 60 years)
• Patients on long-term steroids or immune-suppressives
• Severe ear ache
• Painful burning blisters in and around the ears, on the face, in the mouth and /or on the tongue
• Vertigo, nausea vomiting
• Eye pain or lacrimation
Vesicular exanthema of external ear canal, pinna, post-auricular skin, lateral nasal wall, soft palate and tongue is done to diagnose the infection. Vertigo, hearing loss and facial palsy may be present.
Vaccination is required for all the people older than 60 years of age even if they have chicken pox or zoster in the past.
Anti-viral agents play an important role in limiting the duration and severity of symptoms, especially if started with in 48 hours. Acyclovir, Famcyclovir and Valacyclovir are three commonest drugs used.
Systemic steroids are used to relieve pain, decrease vertigo and limit the occurrence of post herpetic neuralgia.
Is herpes zoster (Shingles) contagious?
Herpes zoster oticus is not contagious. However, you can contract chicken pox from someone with shingles if you have not had chicken pox before. You cannot get shingles from someone who has shingles.