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Suggest Treatment For Herpes Zoster Oticus
Question: I have had an ear/head ache (helped with 4-6 hour Tylenol) for over a week. I have seen a doctor who put me on a nose spray (suggesting I had a small amount of fluid behind my ear drum) . No results from that. I have now been on an antibiotic for 4 days - no results. It's been suggested (not yet by my GP) that I might have herpes zosta. Where do I go from here? An ear-nose-throat specialist? I've had a rash on my face but not the shingles variety. It's red but scaly, not painful or itchy.
Brief Answer:
otitis media more likely
Detailed Answer:
Hello and Welcome
I appreciate your concern
Herpes zoster oticus is due to a viral infection of the ear (outer, middle and inner). It presents as severe earache associated with vesicular eruptions. Its called XXXXXXX hunt syndrome when there is associated facial paralysis. Even if it is herpes zoster or herpes zoster oticus, antivirals are effective only if they are given within 72 hours of onset. Antivirals at this stage wont help much. Post herpetic neuralgia can be minimized by gabapentin and amytriptiline use in consult with your doctor. The lesions of herpes zoster are exquisitely painful and it doesn't present with a painless or itchy rash on the face. Culture sensitivity testing for any ear discharge should be done and antibiotics can be reviewed for a change to a broader spectrum if the empiric treatment fails. Yes, an ENT specialist would be the ideal choice. Based on your history its unlikely to be herpes zoster and appears to be a case of otitis media. Mefenamic acid for pain, Decongestants like xynosine nasal spray with antihistamines such as desloratidine can also be prescribed as additional therapy to the antibiotics e.g cefaclor or augmentine for adequate resolution.
Wishing you best of health
Thanks
Please consult your doctor before deciding on any further course of action.
For future follow up / correspondence you may ask me directly at the link given below
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107
Dr. M.S. Khalil
otitis media more likely
Detailed Answer:
Hello and Welcome
I appreciate your concern
Herpes zoster oticus is due to a viral infection of the ear (outer, middle and inner). It presents as severe earache associated with vesicular eruptions. Its called XXXXXXX hunt syndrome when there is associated facial paralysis. Even if it is herpes zoster or herpes zoster oticus, antivirals are effective only if they are given within 72 hours of onset. Antivirals at this stage wont help much. Post herpetic neuralgia can be minimized by gabapentin and amytriptiline use in consult with your doctor. The lesions of herpes zoster are exquisitely painful and it doesn't present with a painless or itchy rash on the face. Culture sensitivity testing for any ear discharge should be done and antibiotics can be reviewed for a change to a broader spectrum if the empiric treatment fails. Yes, an ENT specialist would be the ideal choice. Based on your history its unlikely to be herpes zoster and appears to be a case of otitis media. Mefenamic acid for pain, Decongestants like xynosine nasal spray with antihistamines such as desloratidine can also be prescribed as additional therapy to the antibiotics e.g cefaclor or augmentine for adequate resolution.
Wishing you best of health
Thanks
Please consult your doctor before deciding on any further course of action.
For future follow up / correspondence you may ask me directly at the link given below
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107
Dr. M.S. Khalil
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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