Recurrent Shingles

[Louloubell]

I am a young healthy (34yo) female.  I had my first outbreak of shingles when I was 20 years old and would break out about once a year around the same time and in the same general area.  From 2005 to this past December 2007 I was outbreak free, but had the rash and symptoms reoccur in the same area only with more generalized pain in my right thigh versus the normal localized pain on my right hip.  Since that outbreak I have had 2 more outbreaks of shingles the most recent starting today.  I did notice that with Valtrex the last time my symptoms resolved much more quickly.  I'm wondering why I am having such frequent outbreaks and has anyone else encountered this?

[maatson]

While I am only addressing the diagnostic dilemma of a doctor working in the third world, and the economics involved here, a definitely diagnosed recurrent zoster patient,as I understand can get a zoster vaccine to prevent further recurrence.
Also I am well aware that recurrent zoster in the immunocompetent is more recognized today than ever before.
I thank you for addressing the issue here.
Cheers.

[maatson]

Another reason for proper diagnosis is the
risk of instituting improper treatment, which can cause
complications.
Incorrect diagnosis of HSV infection as VZV infection
will therefore eventually lead to increased inconvenience,
cost and time incurred by both patients, hospitals and
employers.
(8)8. Kalman CM, Laskin OL. Herpes zoster and zosteriform herpes
simplex virus infections in immunocompetent adults. Am J Med 1986;
81:775-8
Kindly check with your doc.
Best wishes.

[omgnowwhat]

alot of the same story, new illness, another outbreak. Every specialist says I have an autoimmune problem, but no 2 agree on which one. I just found a primary willing to call in a valtrex rx when I feel it happening, or know it's gonna. If I am going to have a surgery or prolonged pain or high stress-I just know. I have heard everything from fibromyalgia to reynaud's to lupus. I thought I had poison ivy my first time, and let it go almost 5 weeks before I went to the doc for cortisone-lol. I had never even HEARD of shingles. By then the damage was done. Sooner you start antivirals, less pain and scarring-and chance of PHN later.

[omgnowwhat]

Kind of obnoxious that you, who have never seen any of these people, or me for that matter, can just decide it's simplex 1 or 2. Do you think we diagnosed this ourselves on WebMD? I've been to my primary doctor, who took a culture for complete lab testing, and two Neurologists specializing in PHN during recurring outbreaks for additional testing. I had my first outbreak after my second lumpectomy. I thought I had poison ivy, after a month I saw my primary. By then the damage was done. Who gets shingles at 35? My second outbreak was post mastectomy in the hospital, and once I conviced the doctors it wasn't a reaction to the antibiotic, valtrex cleared it in 2 days (after 3 days of trying different antibiotics). Every major stress or procedure since has been a recurrence. Just had knee microfracturing done, and guess what? Shingles two days later! Now I'm 39. The truth is they know about zilch about the how and why this happens in certain groups of younger people, but it does. Everything they knew in the last 10 years has been "edited." For those of you also suffering, you know the feeling, when it's starting. Find a primary willing to keep a 10 day course of Valtrex as a call in or with refills on hand. Sooner you start, lesser the suffering and scarring.

[maatson]

In conclusion, as demonstrated in this
case report, recurrent “zosteriform” eruptions caused
by HSV infection can mimic herpes zoster infection.
We recommend the use of laboratory test for accurate
diagnosis, in order for proper treatment and isolation
protocols to be instituted.

[maatson]

Zosteriform herpes simplex
smj.sma.org.sg/4902/4902cr9.pdf

This reference should answer you.
Regards.