I Encounter a Rare Disease - The Life of a Hotel Doctor

A man suffered a headache on his flight. After arriving at the hotel, he felt severe pain in his left ear.

When he opened the door, I noticed that the left side of his face drooped.

Nothing pointed to the usual ear infection. He had no cold symptoms. The plane's descent did not aggravate symptoms. He didn't swim or use q-tips. He did not have a fever.

When I looked inside the ear canal, I saw blisters.

Painful blisters in the canal and a droopy face…. In forty years of practice, I had never seen a case of Ramsay-Hunt syndrome, but there it was. The poor man had shingles inside his ear.

Shingles is a viral infection of skin nerves. It's fairly common and usually appears as a patch of painful blisters on the chest, abdomen, or back, sometimes the face. But there is skin in your ear canal. An additional complication occurs because a nerve passing through the canal feeds muscles of the face, so Ramsay-Hunt victims experience facial paralysis on that side.

Treatment is an antiviral drug and a course of cortisone which is modestly but not dramatically effective. Most victims recover, but he would have an uncomfortable few weeks.