A 75 year old woman has weakness of the left side of her face. She has had a painful ear for 48 hours. There are pustules in the left ear canal and on the eardrum. What is the single most likely diagnosis?

The key is B. Herpes zoster infection. [A case of Ramsay Hunt syndrome defined as an acute

peripheral facial neuropathy associated with erythematous vesicular rash of the skin of the ear canal,

auricle (also termed herpes zoster oticus), and/or mucous membrane of the oropharynx caused by

Herpes zoster infection].