Document Type : Case Report
Department of Emergency and Critical Care Medicine, Aizawa Hospital, Nagano, Japan
Introduction: Cruises are one of the major travel industries worldwide and a variety of medical issues can happen onboard. This is a case report of peripheral facial nerve palsy in an elderly man with diabetes treated onboard a world cruise ship.
Case Presentation: A 78-year-old man presented to the infirmary due to difficulty closing his left eye during a 105-day world voyage. The patient was in a good general health and had a history of hypertension and diabetes mellitus (treated by dietary intervention). He was diagnosed with severe Bell’s palsy by history and physical examination and treated with prednisolone and valacyclovir without any complications and a near-complete recovery. The possibility of misdiagnosis and deterioration of diabetes mellitus due to the corticosteroid treatment was explained to the patient.
Conclusion: When it comes to medical management in a resource-limited setting like cruise ships, passenger physicians trained in a wide variety of illnesses are crucial. It is important to explain to patients the prognosis and expected outcome of the medical condition. Emergency medical evacuation may be warranted in certain cases.