OpenHealth Q&A

Has My Immune System Let Me Down?

At 31 years old, I am dealing with generalized anxiety disorder (GAD) and depression, as well as conditions like GERD and IBS. I am currently taking a regimen that includes Cymbalta 30mg once a day, Buspar 7.5mg twice daily, and Remeron 7.5mg once daily. In my recent medical journey, I have been struggling with chronic musculoskeletal pain that manifests in various forms, locations, and levels of severity. Accompanying this are excessive night sweats, hypermobility in nearly all of my joints, among other issues. I’m collaborating with my general practitioner, rheumatologist, and orthopedic specialist, and I have a scheduled appointment with a neurologist at the end of this month. Although extensive blood tests have been conducted, no definitive diagnosis has been made yet. On January 14, I received a tetanus vaccine in my left shoulder and a flu shot in my right. That evening, however, I began experiencing significant pain in my right shoulder, rating it a 7 out of 10 on the pain scale. It felt unstable and would occasionally slip out of position. Given my medical history, I initially suspected I was overreacting to the vaccine and anticipated the pain would subside after a few days, but I was mistaken. After suffering for approximately 3 to 4 weeks, I visited the clinic where I was prescribed oral steroids. This reduced my pain by 40% to 50%, but any significant movement of the arm or shoulder caused the pain to return intensely. After several more weeks, I returned to my general practitioner to discuss treatments like lidocaine patches and topical creams, which offered minimal relief. Last Friday, I consulted an orthopedic specialist and received a steroid injection into the bursa—please forgive the terminology if I’m off. Now, a week later, my shoulder has regained much of its mobility, although it still feels weak. However, this morning as I was going about my daily routine, I noticed an itch on my shoulder, right where the injection took place. Upon checking in the mirror, I was surprised to see a raised, red ring forming on the back of my shoulder in the injection area. I asked my husband about it, and he confirmed that the bandage applied after the injection was not round. I promptly called the orthopedist’s office to report my findings, and they advised me that this wasn’t typical and suggested I visit the clinic for an evaluation. The clinic officials somewhat validated my concerns, expressing it could be ringworm, but the nurse practitioner was rather uncertain about it. I’m puzzled as to how I could have possibly acquired ringworm. I primarily work from home, mostly interacting with my husband and kids, especially since we’ve recently relocated and I have yet to meet new people. While I do have two indoor cats, they’ve shown no signs of ringworm whatsoever. Hence, I’m left pondering: How does the immune system operate in a manner that would lead to developing ringworm precisely in the area where I have been grappling with chronic issues? If I were to contract ringworm, why would it show up on my shoulder, particularly at the site of the injection? In summary: ongoing inflammation from the flu vaccine ➔ steroid shot in the shoulder ➔ ringworm at the injection site ➔ what on earth is going on?

Answers (1)

4/4/2025, 4:11:11 PM

OpenHealth AI

It's understandable to feel confused and concerned about your current situation, especially with the combination of chronic pain, recent vaccinations, and now a possible skin condition. I'll address your primary concerns regarding the immune system and the symptoms you've described.

Key Points:

1. Immune Response and Infections: Your immune system plays a critical role in defending against infections like ringworm (a fungal infection). Factors like chronic inflammation or medications (like steroids) can sometimes alter the immune response.
2. Possible Skin Reaction: The raised, red ring on your shoulder might indicate several conditions, including a localized reaction to the steroid injection, or a fungal infection such as ringworm, which can emerge due to various reasons.

Explanation:

The immune system typically helps prevent infections but can be compromised or altered by chronic conditions, medications, or local trauma (like an injection site). If steroids are involved, they can reduce inflammation but might also lower immune defenses temporarily, making you more susceptible to infections.

Ringworm itself is not caused by poor immunity; it's a fungal infection that can appear when the fungus has the opportunity to infect the skin. Sometimes, it can develop at sites of skin irritation or trauma, such as where an injection was given, especially if moisture is present.

Next Steps:

1. Monitor Skin Changes: Keep a close eye on the raised, red area. Note any changes in size, color, or if it develops symptoms like itching or scaling.
2. Limit Moisture at Injection Site: Keep the area dry and clean. Avoid tight clothing that might irritate the skin further.
3. Consider a Follow-Up Evaluation: Since the initial advice was uncertain, schedule an appointment with a dermatologist for a definitive diagnosis. A skin culture or examination can confirm if it is ringworm or another issue.
4. Maintain Open Communication with Your Healthcare Team: Share these observations with your doctors, especially the orthopedist and your general practitioner. They may suggest appropriate topical treatments or further diagnostic tests.
5. Support Your Immune System: Ensure you're eating a balanced diet rich in vitamins and minerals, staying hydrated, and getting adequate sleep. These can have a positive impact on your overall immune function.

It's perfectly normal to feel a bit overwhelmed given everything you're managing. Take things one step at a time, and remember, support is available from your healthcare providers. Don't hesitate to reach out with any further questions or concerns about your symptoms or treatment options.