HSC Section 3 - Trauma, Critical Care and Sleep Medicine

O

High-dose steroids: Prednisone 60 mg 5 days, followed by a 5-d taper Antiviral: Valacyclovir 1 g BID 7d

Highly active antiretroviral therapy (HAART)

Eye care: lubricants, shield PT: eyelid stretch Doxycycline 100 mg PO BID 10–21 d or Cefuroxime 500 mg PO BID, 14–21 d

or Amoxicillin 500 mg PO BID, 14–21 d Per recent CDC guidelines steroids

Table 1 Differential diagnosis of acute facial paralysis Diagnosis Category Diagnosis Clinical Signs/Symptoms Etiology Diagnostics Acute Management Infectious Bell palsy Fully progresses to flaccid facial paralysis (FFP) within 72 hours Viral prodrome Herpes simplex virus (HSV) reactivation No serology Consider ENoG and EMG Eye care: lubricants, shield Physical therapy: eyelid stretch Medications: Varicella zoster virus (VZV) Audiogram Per BP Ramsay Hunt syndrome

Serology *Antiviral, steroids

cerebrospinal fluid antibodies

Serum and

Bacterium: Borrelia

immunodeficiency virus

burgdorferi

via tick bite

Human

HIV Viral symptoms, early (seroconversion) or late stages

Lyme disease Headache, fatigue, fever, arthritis

"Erythema migrans" (bull’s eye) rash, outdoors activity

Otalgia, vestibulocochlear symptoms Vesicles

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