Why a Young, Healthy Tourist Got Severe Shingles in Vietnam

Hoa said the case was unusual precisely because the patient was young, healthy and had no underlying conditions. Shingles is best known for its lingering aftereffect, post-herpetic neuralgia, the nerve pain that can persist for months after the rash fades. The bacterial skin infection seen here is a less-recognized complication, Hoa said, and one that can move quickly.

In this patient the lesions seeded an infection that sank into the tissue beneath the skin and tracked along the lymphatic system within a short window. Left unchecked, Hoa said, such an infection can spread further and raise the risk of sepsis and septic shock.

The patient was put on antiviral medication along with intravenous antibiotics. The swelling and pain eased within a day. After three days the lesions had improved enough for him to be discharged for outpatient follow-up.

In a handwritten note to the hospital after recovering, he said that during a frightening stretch of his trip he had felt safe and well looked after, crediting staff who kept in close contact and helped even outside working hours.

City International Hospital, a private facility, is one of six hospitals in Vietnam licensed to treat foreign patients and reports more than 30,000 international visitors a year, part of a medical tourism sector the country has been working to grow.

Hoa urged anyone with shingles not to brush off warning signs: lesions that spread quickly, pain that keeps building, or red streaks reaching beyond the original rash. Each can mark an infection that needs treatment without delay.