Case presentation - A 35-year-old previously healthy man presented to the emergency department with a left-sided facial palsy (Fig 1. Panel A). Four days before, he complained of left ear pain with hearing loss and tinnitus and received antibiotics for a presumed infection. He then developed voice impairment and inability to swallow properly. On examination, his left ear was erythematous and vesicles were seen both in the auricle and in the external auditory canal (Fig. 1. Panel B), without any lesion in the oral cavity.
