My mother had shingles once few years(~5) ago. She is 82 yo and was diagnosed with CLL there are 6 years. Was on Rituxan and chlorambucil combination treatment already twice (each treatment with few cycles , treatments 3 years apart) and now was prescribed and started taking ibrutinib 6 weeks ago. Her immunity is very low. Today she started to complain about pain in the same place she had shingles 5 years ago. She is taking only ibrutinib (420 mg/day), no antiviral . Recovering from pneumonia that collapsed the middle lung lobe on the right lung a couple of weeks ago. WBC was around 90000 6 weeks ago and went up to 200000 one week ago(and I think and hope this is expected). RBC : Hematocrit 29%, Hemoglobin 8.7, platlets 95000 . Should we suspect shingles are coming back? How to confirm? Any preventive measure?