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Acute laryngitis and acute inflammatory diseases of either infectious or non-infectious causeshave similarities with herpes zoster of the vagus nerve (VHZ). We present a case which wasinitially diagnosis wtih acute laryngitis but finally diagnosed as VHZ. A 41-year-old male presentedwith an ongoing fever, throat pain and right otalgia lasting for two days with worseningsymptoms despite nonsteroidal anti-inflammatory drug medication. Initially, he was treatedconservatively as acute laryngitis was suspected. However, VHZ was subsequently diagnosedin this patient after considering unilateral auricular and laryngeal vesicles which were followedby ipsilateral vocal fold paresis. An antiherpetic agent and prednisolone were administeredupon the presentation of vocal fold paresis. Axonotmesis was discovered by laryngealelectromyography one week after the appearance of vocal fold paresis. All symptoms subsidedafter one month. These results highlight the importance of understanding vagus nerve functionin developing a differential diagnosis for laryngitis and VHZ.
