Red ear syndrome precipitated by a dietary trigger: a case report

Journal of Medical Case Reports

Susmita Ghosh²  Chung Chi Chan¹ 

[1] Department of Adult Audiovestibular Medicine, Royal National Throat, Nose and Ear Hospital, 330 Grays Inn Road, London WC1X 8DA, UK;Department of Audiovestibular Medicine, Platt Bridge Health Centre, Rivington Drive, Bickershaw, Wigan WN2 5NG, UK

关键词: Red ear syndrome;    Migraine;    Lifestyle modifications;    Erythema;    Dietary trigger;   

Others  :  1181015
DOI  :  10.1186/1752-1947-8-338

 received in 2014-05-01, accepted in 2014-08-20,  发布年份 2014

【 摘 要 】

Introduction

Red ear syndrome is a rare condition characterized by episodic attacks of erythema of the ear accompanied by burning ear pain. Symptoms are brought on by touch, exertion, heat or cold, stress, neck movements and washing or brushing of hair. Diagnosis and treatment of this condition are challenging. The case we report here involves a woman whose symptoms were brought on by a dietary trigger: orange juice as well as stress, causing significant physical and psychological morbidity. Avoidance of triggers resulted in symptomatic improvement.

Case presentation

A 22-year-old Caucasian woman who was a student presented twice to our department with evolving symptoms, the first time with hyperacusis (abnormal sound sensitivity arising from within the auditory system to sounds of moderate volume), intermittent right tinnitus and subjective hearing difficulties. She presented five years later with highly distressing episodes of erythematous ears, which were associated with burning pain around the ear and temporal areas, and intolerance to noise. After keeping a symptom diary, she identified orange juice and stress as triggers of her symptoms. No local head and neck pathology was present. Investigations and imaging were negative. Avoidance of triggers led to great symptomatic improvement. To the best of our knowledge, dietary triggers have not previously been reported as a trigger for this syndrome. This case shows a direct temporal link to a dietary trigger and supports a primary pathogenesis. Recognition and management of primary headache disorder and simple dietary and lifestyle changes brought about symptomatic relief.

Conclusion

Red ear syndrome is a little-known clinical syndrome of unknown etiology and management. To the best of our knowledge, our present case report is the first to describe primary red ear syndrome triggered by orange juice. Clinical benefit derived from avoidance of this trigger, which is already known to precipitate migraines, gives some insight into the pathogenesis of red ear syndrome.

【 授权许可】

   
2014 Chan and Ghosh; licensee BioMed Central Ltd.

【 图 表 】

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