Ramsay Hunt Syndrome in a Living-donor Kidney Transplantation Recipient: Unusual Clinical Course Case

Dawn Jung; Sung Hoon Kim; Seung Ok Choi; Sang You Park

doi:10.4285/jkstn.2016.30.2.86

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Jung, Kim, Choi, and Park: Ramsay Hunt Syndrome in a Living-donor Kidney Transplantation Recipient: Unusual Clinical Course Case

Case Report

J Korean Soc Transplant 2016;30(2):86-88.

Published online: 19 January 2016

DOI: https://doi.org/10.4285/jkstn.2016.30.2.86

Ramsay Hunt Syndrome in a Living-donor Kidney Transplantation Recipient: Unusual Clinical Course Case

Dawn Jung, M.D.¹, Sung Hoon Kim, M.D.^1,, Seung Ok Choi, M.D.², Sang You Park, M.D.³

¹Departments of Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea

²Departments of Surgery, Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea

³Departments of Surgery, Otorhinolaryngology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea

Corresponding author: Sung Hoon Kim Department of Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea Tel: 82-33-741-0573, Fax: 82-33-741-0574 E-mail: drgs01@yonsei.ac.kr

Received 18 November 2015 Revised 18 March 2016 Accepted 28 March 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Varicella zoster virus (VZV) infection is due to VZV reactivation in most cases. The infection rate ranges from 4% to 12% in renal allograft recipients. Ramsay Hunt syndrome (RHS) is a rare manifestation of VZV infection. RHS typically presents as severe ear pain, small vesicles, and facial palsy. We reported a case of a 60-year-old man with an unusual clinical course who underwent living donor renal transplantation. He complained of severe ear pain but did not show vesicles or facial palsy. He also presented lesions indicating a fungal infection. Diagnosis of RHS was delayed since facial palsy did not develop until some days later. Although the denervation rate was high, he showed recovery of nearly all symptoms after antiviral treatment. Solid organ recipients may not typically show presentation of viral infection, and therefore clinical suspicion is important. Even though the final diagnosis is delayed, we must treat patients since they may recover well in contrast with the average population.

Keywords: Kidney transplantation, Human herpesvirus 3, Herpes zoster oticus

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