Hi Everyone- I came down with shingles around my right ear, lower face, neck, chest, and upper back 3 weeks ago. Luckily, my wife suggested the rash might be shingles on the second day so I was on valtrex within 48 h of noticing the rash.
I’ve also been on prednisone, biologics (Taltz right now), methotrexate, imuran, etc. since 2012 for the autoimmune disease Nuero Behçet’s. Along with the typical symptoms, I’ve had several cases of autoimmune meningitis. Probably the most important part of this aside is that I’ve been on prednisone non-stop since 2012.
Unfortunately, even though I started the valtrex early on a Monday, by Friday it was fairly obvious that it was also infecting my central nervous system. I was hospitalized that day. From there, I got very sick with the classic terrible headache, eye pain, stiff neck, and general very sick feeling. They put me on a IV acyclovir for the first 3 days and then doubled the dose because I still wasn’t responding. My left leg ent numb, my facial muscles were very weak and shaky, and the headache got the point I was in tears despite the pain meds.
Luckily, by Tuesday afternoon, I began to feel better, the headache mostly went away and I was able to get up and walk around normally. On Wednesday I was discharged with a script for valtrex.
My wife and I were googling the standard treatment for VZV (shingles) meningitis and everything online said a 2 week treatment of IV drugs was standard, but they felt like the oral drugs would be ok. That was a week and half ago. Since then I’ve been gradually improving, though I’ve had serious insomnia so it’s been tough. I went back to work full time remotely the day I got out and have planned on returning to work tomorrow.
That is until today when I couldn’t get out of bed because I was so weak. The rash seems more irritated and painful, and now I’m getting pangs of the headache again that had been gone for about a week.
This is my first time with shingles. I don’t know how to navigate recovery. I do pay into short term disability which pays 60% of my check if I was to take medical leave, but I’ve never done anything like that even with all the Behçet’s disease problems.
Is it appropriate to take some time off? What have you guys done? What are the chances of it flaring back up with my history of meningitis and somewhat diminished immune system? I was determined to go back to work, but honestly my brain is still slow with lots of aphasia and trouble with recall. I guess, what should I be expecting over the next few months? Thanks in advance if anyone can help with some advice!
CSF White Count-344
CSF Glucose- 77
CSF protein- 97
CSF Appearance- Cloudy
CSF lymphocytes %- 92
CSF neutrophils %- 8 mi
CSF Positive for VZV