Seven zoster reactivations in an immune competent patient: how many is too many?

Herpes zoster virus (HZV) reactivation is commonly reported in elderly or immune compromised patients. However, certain presentations are rarely reported in immune competent patients. Here we report a rare case of recalcitrant HZV infection, including 7 reactivations over 3 years, in an immune competent patient. Due to the pain experienced, this patient self-referred to our clinic, and thus bypassed other specialties. As pain management specialists, it is critical to be aware of such presentations, the clinical implications involved, and management options to consider.