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Having ear pain, ringing ear, dizziness, fluid filled blisters in ear canal. What does this mean?

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ENT Specialist
Practicing since : 1991
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What could this mean? right ear pain, facial weakness, ringing in the right ear, dizzy, like the room is spinning. Taste buds aren’t working well, right face is droopy, can’t close right eye and it feels dry. There is a red rash with fluid filled blisters inside the right ear canal and at tragus. Have a scant clear nasal drainage.
Posted Wed, 25 Jul 2012 in General Health
 
 
Answered by Dr. Sumit Bhatti 5 hours later
Hi,

Thank you for your query.

1. Wth the addition of the symptoms (to your previous query) of facial weakness (including the inability to close your right eye) and altered taste, the diagnosis is XXXXXXX Hunt Syndrome Type 2 (Herpes Zoster Oticus or Shingles).

2. Involvement of the vestibulocohlear nerve near the geniculate ganglion of the facial nerve may be the reason for vertigo.

3. Herpes occurs due to the reactivation of dormant chickenpox virus which may have caused chickenpox in childhood.

4. Treatment includes immediate administration of antivirals such as Acyclovir (Zovirax) 800 mg 5 times a day for a week or two (oral) and Acyclovir (Zovirax) ointment locally along supportive medication for pain relief, vertigo and steroids a little later to aid the recovery of the nerves. Other antivirals are Famcyclovir and Valcyclovir.

5. Please get yourself examined by an ENT Specialist (who can see the eardrum) and a Skin specialist immediately.

6. Though the infection is self limiting, it may have many complications such as incomplete or delayed recovery, permanent facial palsy, loss of hearing or vertigo, taste, meningism and post herpetic pain. Reinfections after recovery are rare.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Having ear pain, ringing ear, dizziness, fluid filled blisters in ear canal. What does this mean? 9 hours later
Thank yo for your answers Dr. Bhatti:

I will see a dermatologist and an ENT, as you recommended. I had chicken pox as a child. I did not think that I would have issues with it again at 65! All of these symptoms are happening only in the right ear: pain, ringing, and the red rash with fluid-filled blisters in the right ear canal, and I already cannot hear. Will this spread to my left ear? Is that the reason for my lymph glands to be swollen in front of the right ear and the right front neck? I also have a scant clear runny nose. I know I should stop smoking, I have COPD. I am going to get treated for Herpes Zoster Oticus.
Thank you for your time and the wealth of information!
 
 
Answered by Dr. Sumit Bhatti 19 hours later
Hi,

Thank you for your query.

1. Herpes zoster oticus is common in the sixth decade.

2. This will not spread to the other (left ear). The infection spreads along the route of the infected nerve (dermatome). It may start separately on the other side, but this is very rare.

3. The lymph nodes are swollen due to this infection and inflammation.

4. Smoking and COPD have no direct link with Herpes zoster oticus. However you should reduce or stop smoking. In my experience, a herpes reactivation many a times signifies some stress or weakness in the body which allows the dormant virus to surface again.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Having ear pain, ringing ear, dizziness, fluid filled blisters in ear canal. What does this mean? 1 hour later
Hi Dr. Bhatti:
I have been told that I should stay away from my grandkids at this time, until all is crusted over because this is highly contagious, they have not yet gotten the chicken pox. Since I got this at this age, is there a possibility that if they get the chicken pox, then they will get this XXXXXXX Hunt Syndrome 2 later on in their lives? I mean is this genetic? I have been under a lot of stress at work, you are right, and I have not been able to get enough sleep the past few days.

Thank you for all the information,
 
 
Answered by Dr. Sumit Bhatti 5 hours later
Hi,

Thank you for writing back.

1. Yes,you should isolate yourself from your grandchildren especially if they have not yet gotten chickenpox. If your grandchildren are more than one year old, they may have received Varicella Vaccine. In that case the risk of exposure is less (they may already be immune) and even if they do get chickenpox, it will be a mild illness.

2. The vesicles are infectious till the scabs are formed. This is a highly contagious infection. Usually the infectivity of these viral infections starts before the rash prodromal period) and therefore it is humanly impossible to avoid exposure.

3. It is not genetic and there is no way of predicting whether your grand children will ever suffer from XXXXXXX Hunt Syndrome, Type 2 in the future. It may never happen as external factors such as stress or XXXXXXX weakness are involved.

4. However I have seen this occur in parents and siblings. It may reflect the virulence of that particular strain of the chickenpox virus.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
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