Herpes Simplex Virus Reactivation and Candida glabrata Fungemia Following Short-Term Corticosteroids in a Patient With Septic Shock.

Opportunistic infections such as herpes simplex virus type 1 (HSV-1) reactivation and fungemia are traditionally associated with chronic or profound immunosuppression. However, emerging evidence indicates that even brief, high-dose corticosteroid therapy can transiently impair immune function and predispose critically ill patients to severe secondary infections. We present a case of a 52-year-old man with multiple comorbidities who developed HSV-1 dermatitis with gingivostomatitis and fungemia following a short course of corticosteroids administered for septic shock. The patient's HSV-1 dermatitis was treated with acyclovir, and fungemia was treated with micafungin. This dual infectious complication occurred despite the absence of prolonged immunosuppressive therapy or invasive mechanical ventilation. The case underscores the underrecognized immunosuppressive potential of short-term corticosteroids in the intensive care unit (ICU). It highlights the need for heightened clinical vigilance, especially in patients with predisposing factors such as diabetes, renal impairment, and recent surgical instrumentation.