Ramsay Hunt Syndrome and Blood Clots
This article highlights one of my patients who had Ramsay Hunt Syndrome that was initially mistaken for a bacterial cellulitis because her ear was red and swollen. The herpes zoster/shingles blisters were inside her ear so it was important that the health care provider look in the ear canal and eardrum for lesions for an accurate diagnosis and treatment.
Whenever I have patients with herpes zoster/shingles, I caution them that they are at an increased risk for stroke and heart issues over the following year. Thus, if they have stroke symptoms (new numbness, weakness, headache, slurred speech, confusion) or chest symptoms (chest pain, palpitations), they should go the the emergency room right away. This patient developed 2 neurological events caused by venous blood clots. At the time, this was unusual because we viewed VZV vasculopathy as direct virus infection of arteries not veins. Now, we have found that herpes zoster/shingles increases risk of clotting, in part, through circulating prothrombotic exosomes.
