An 80-year-old woman, named Hoa, with a history of hypertension, stroke, atrial fibrillation, heart failure, and drug-induced adrenal insufficiency, experienced a shingles outbreak. She frequently suffered from respiratory infections and asthma, often self-medicating with drugs of unknown origin. For two months prior to the outbreak, she experienced fatigue, poor appetite, weight loss, and shortness of breath.

Dr. Hoang Thi Binh of the Cardiology Department at Tam Anh General Hospital in Ho Chi Minh City diagnosed Hoa with severe pneumonia and heart failure. After 10 days of treatment, her breathing improved, and the lung infection subsided. However, she then developed pain in her left ear, along with fatigue and insomnia. Small, clustered blisters appeared behind her left ear and spread down her left neck, indicating a shingles outbreak.

Dr. Huynh Thanh Kieu, Head of the Cardiology Department 1 at Tam Anh General Hospital, explained that Hoa's obesity, multiple underlying health conditions, chronic adrenal insufficiency from long-term corticosteroid misuse, and acute pneumonia weakened her immune system, allowing the varicella-zoster virus (VZV) to reactivate and cause shingles.

Hoa received antiviral medication. After 4 days, her ear pain lessened, the blisters began to dry, and the burning sensation subsided. She was discharged after two weeks. Doctors advised her to maintain good hygiene to prevent infection and ensure effective treatment. After a few months, once her condition stabilizes, she was recommended to receive the shingles vaccine to prevent recurrence.

Dr. Binh checks on the patient two weeks after treatment. Photo: Ha Vu

Dr. Binh checks on the patient two weeks after treatment. Photo: Ha Vu

Shingles, also known as herpes zoster, is a viral infection caused by VZV. Initial infection with VZV causes chickenpox. After chickenpox resolves, the virus remains dormant in the nerve ganglia for months or years, reactivating under favorable conditions such as weakened immunity, stress, or physical exhaustion. Shingles can persist for years after the skin lesions have healed.

According to Dr. Kieu, some medications of unknown origin often contain corticosteroids. Self-medicating with these drugs, particularly among patients with bone and joint diseases or asthma, is a primary cause of secondary adrenal insufficiency, which weakens the immune system. Patients requiring long-term corticosteroid use should consult a doctor for appropriate dosage and treatment plans.

To prevent shingles, avoid contact with individuals with active blister outbreaks. Individuals with multiple underlying health conditions, weakened immunity, or those 50 years and older should consider vaccination. Maintaining a healthy lifestyle through sufficient sleep, abstaining from smoking, and following a balanced routine also strengthens the immune system.

Thu Ha