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A 15-year-old girl presented with left ear pain and vertigo, exacerbated by head movements. She described vertigo as a sensation of motion of the environment. Physical examination showed hyperaemia and oedema of the auricle and of the external auditory canal. Persistent, spontaneous, horizontal, grade II right-beating nystagmus, under Frenzel’s glasses, was noted. Bedside examination of vestibulospinal reflexes (Romberg test, past pointing test, tandem, walking and stepping tests) showed a shifting towards the left, indicating a static imbalance. Oral therapy with ciprofloxacin at 20 mg/kg in two doses was started. Three days later, ear pain and vertigo persisted and worsened. On re-evaluation, a painful vesicular and crusty rash in the left auditory canal and auricle was noted (figure 1).
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