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No es un ictus, sino un virus: Cuando una llamada confusa cuenta una historia diferente
Inês C Teixeira1, Filipa Andrade2, Sara Gouveia1
1Family Medicine, Centro de Saúde do Bom Jesus, ACES Madeira SESARAM, Funchal, PRT.
Cureus
|December 31, 2025
Resumen
El síndrome de Ramsay Hunt (SRH) atípico en un varón de edad avanzada se presentó con parálisis facial y erupción cutánea. El diagnóstico y tratamiento tempranos son cruciales para obtener mejores resultados en esta reactivación del VZV.
Área de la Ciencia:
- Neurología
- Enfermedades Infecciosas
- Dermatología
Sus antecedentes:
- El síndrome de Ramsay Hunt (SRH), causado por la reactivación del virus de la varicela-zóster (VVZ), se presenta típicamente con parálisis facial, erupción cutánea y problemas auditivos.
- Las presentaciones atípicas pueden complicar el diagnóstico, especialmente en pacientes de edad avanzada con comorbilidades.
Objetivo del estudio:
- Informar sobre un caso de SRH atípico con manifestaciones cutáneas inusuales y resaltar los desafíos diagnósticos y pronósticos.
- Enfatizar la importancia de la intervención temprana y la atención multidisciplinaria para optimizar los resultados del paciente.
Principales métodos:
- Informe de caso de un varón de 71 años con enfermedad cardiovascular que presenta disartria, parálisis facial y lesiones del dermatoma C2-C3.
- El tratamiento incluyó terapia antiviral, antibiótica y con corticosteroides, seguida de rehabilitación.
Principales resultados:
- El paciente experimentó un diagnóstico tardío debido a una presentación atípica, lo que provocó déficits motores graves y dolor neuropático crónico.
- La superinfección bacteriana y la pérdida de audición neurosensorial complicaron el curso clínico.
Conclusiones:
- Las presentaciones atípicas del SRH y el diagnóstico tardío impactan negativamente en el pronóstico, lo que subraya la necesidad de un tratamiento antiviral y con corticosteroides rápido.
- La atención integrada es esencial para el manejo de las secuelas y el mantenimiento de la calidad de vida en pacientes de edad avanzada con comorbilidades.
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