Review Question - QID 213528

A 65-year-old man presents to the emergency department with ear pain and is concerned that he has had a stroke. The patient states that this morning he had trouble moving one side of his face. Otherwise, he has noticed worsening ear pain over the past 2 days. The patient has a past medical history of diabetes and hypertension. His temperature is 98.5°F (36.9°C), blood pressure is 153/91 mmHg, pulse is 90/min, respirations are 13/min, and oxygen saturation is 98% on room air. Physical exam is notable for right-sided paralysis of the upper and lower portion of the patient’s face. The rest of the patient’s neurologic exam is unremarkable and he demonstrates normal strength, sensation, gait, speech, and memory. Dermatologic exam reveals the finding in Figure A which is present in the patient’s ear canal. Which of the following is the best next step in management?