A 70-year-old female affected by Waldenström’s Macroglobulinemia, under immunosuppressive therapy with melphalan, was presented to the Emergency Department. History The patient had a medical history of recurrent episodes of herpetic keratitis in the left eye associated with periocular vesicles and erythema due to Herpes Zoster (HZ). The patient underwent a deep anterior lamellar keratoplasty and a penetrating keratoplasty initially. Since the first surgery, the patient had been under prophylactic antiviral therapy with acyclovir.
The patient also underwent a right dacryocystorhinostomy. The patient had developed periocular blistering, swelling, and pain in the same left dermatome of the trigeminal nerve involved in the previous HZ episodes and fever over the past two days. A diagnosis of shingles was made, and the patient was prescribed topical and intravenous acyclovir and then…
