Meningitis retention syndrome caused by varicella zoster virus in a patient without a rash: a case report

Kenzaka, Tsuneaki; Goda, Ken; Kumabe, Ayako

doi:10.1186/s12879-021-06692-6

Cited by 5 publications

(2 citation statements)

References 12 publications

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“…That would explain why these patients also suffer from fever, headache, stiff neck, and minor pyramidal signs. The bladder is initially areflexic [48,49].…”

Section: Meningitis Retention Syndromementioning

confidence: 99%

Herpes zoster: A Review of Clinical Manifestations and Management

Patil

Goldust

Wollina

2022

Viruses

216

123

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The Varicella-zoster virus (VZV) or human herpes virus 3 is a neurotropic human alpha herpes virus responsible for chickenpox/varicella and shingles/herpes zoster (HZ). This review will focus on HZ. Since HZ is secondary to varicella, its incidence increases with age. In children and youngsters, HZ is rare and associated to metabolic and neoplastic disorders. In adults, advanced age, distress, other infections (such as AIDS or COVID-19), and immunosuppression are the most common risk factors. HZ reactivation has recently been observed after COVID-19 vaccination. The disease shows different clinical stages of variable clinical manifestations. Some of the manifestations bear a higher risk of complications. Among the possible complications, postherpetic neuralgia, a chronic pain disease, is one of the most frequent. HZ vasculitis is associated with morbidity and mortality. Renal and gastrointestinal complications have been reported. The cornerstone of treatment is early intervention with acyclovir or brivudine. Second-line treatments are available. Pain management is essential. For (secondary) prophylaxis, currently two HZV vaccines are available for healthy older adults, a live attenuated VZV vaccine and a recombinant adjuvanted VZV glycoprotein E subunit vaccine. The latter allows vaccination also in severely immunosuppressed patients. This review focuses on manifestations of HZ and its management. Although several articles have been published on HZ, the literature continues to evolve, especially in regard to patients with comorbidities and immunocompromised patients. VZV reactivation has also emerged as an important point of discussion during the COVID-19 pandemic, especially after vaccination. The objective of this review is to discuss current updates related to clinical presentations, complications, and management of HZ.

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“…That would explain why these patients also suffer from fever, headache, stiff neck, and minor pyramidal signs. The bladder is initially areflexic [48,49].…”

Section: Meningitis Retention Syndromementioning

confidence: 99%

Herpes zoster: A Review of Clinical Manifestations and Management

Patil

Goldust

Wollina

2022

Viruses

216

123

View full text Add to dashboard Cite

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“…[ 7 ] Because of the low number of reported cases of ES, clinicians are not very cognizant of it and are unable to perform timely imaging or pathogenetic tests for a definitive diagnosis, so outpatient clinics often misdiagnose AUR patients with dyspareunia due to causes such as urethral obstruction because of ignoring their history of herpes zoster. Also because VZV visceral disseminated infection can also occur in immunocompetent people, [ 8 , 9 ] and even patients do not always show skin symptoms after infection, [ 10 ] the onset of which is more insidious. All of the above reasons largely increase the diagnostic difficulty, which makes it difficult for clinicians to treat HZ as one of the triggering causes of acute urinary retention.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture treatment of acute urinary retention caused by varicella-zoster virus through by combining the mechanism of sacral neuromodulation: A rare case report

Tan,

Shen

2023

Medicine

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Rationale: Urinary dysfunction triggered by varicella-zoster virus (VZV) attacking the nervous system seriously affects the quality of life of patients and may even cause irreversible damage to the urinary system. This a 62-year-old man with acute urinary retention triggered by VZV, who was cured after acupuncture treatment. The rational application of acupuncture therapy to promote the recovery of bladder contraction function can effectively relieve the symptoms of dysuria, shorten the course of the disease. Patient concerns: Symptoms included dysuria and distension of the bladder area secondary to postherpetic herpes zoster, with significant pressure and pain in his lower abdomen, accompanied by cutaneous herpes distributed over the sacral region. Diagnoses: The case was diagnosed as acute urinary retention (Neurogenic Bladder). Ancillary tests include urodynamic examination, Doppler ultrasound, urodynamic tests are the preferred diagnostic method and suggest: no contraction of the detrusor muscle is seen during voiding, and voiding occurs in an The absence of abdominal pressure-assisted micturition and repeated attempts to pass urine suggests detrusor weakness; residual urine suggests a severe bladder emptying disorder. Doppler ultrasound suggested overfilling of the bladder, and 1153 mL of residual urine was seen in the bladder after voiding. Interventions: The patient developed sacral herpes and dysuria and was treated with oral antiviral drugs on the 12th day of illness. But his urinary difficulty did not improve but gradually worsened, resulting in acute urinary retention, and he then turned to the acupuncture treatment, innovative approach combined the mechanism of action of sacral neuromodulation with traditional Chinese medicine theory. Outcomes: The duration of acupuncture treatment totaled 12 weeks; he was able to urinate on her own and her symptoms completely disappeared. No other adverse and unintended events occurred during treatment. Lessons: This study demonstrates that acupuncture is safe and effective in the treatment of acute urinary retention caused by VZV, which is worth recommending as a conservative treatment. Moreover, we found that the early intervention and full-term treatment with acupuncture is particularly important, provided that the right key acupoints are selected.

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Meningitis-retention syndrome: a review and update of an unrecognized clinical condition

et al. 2023

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Objectives We summarized the clinical and radiological characteristics of meningitis-retention syndrome (MRS), its therapeutic options, and urological outcome, to better understand the pathogenesis of this syndrome and to evaluate the effectiveness of corticosteroids in reducing the period of urinary retention. Methods We reported a new case of MRS in a male adolescent. We also reviewed the previously 28 reported cases of MRS, collected from inception up to September 2022. Results MRS is characterized by aseptic meningitis and urinary retention. The mean length of the interval between the onset of the neurological signs and the urinary retention was 6.4 days. In most cases, no pathogens were isolated in cerebrospinal fluid, except for 6 cases in which Herpesviruses were detected. The urodynamic study resulted in a detrusor underactivity, with a mean period for urination recovery of 4.5 weeks, regardless of therapies. Discussion Neurophysiological studies and electromyographic examination are not pathological, distinguishing MRS from polyneuropathies. Although there are no encephalitic symptoms or signs, and the magnetic resonance is often normal, MRS may represent a mild form of acute disseminated encephalomyelitis, without radiological detectable medullary involvement, due to the prompt use of steroids. It is believed that MRS is a self-limited disease, and no evidence suggests the effectiveness of steroids, antibiotics, and antiviral treatment in its clinical course.

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Meningitis retention syndrome caused by varicella zoster virus in a patient without a rash: a case report

Cited by 5 publications

References 12 publications

Herpes zoster: A Review of Clinical Manifestations and Management

Herpes zoster: A Review of Clinical Manifestations and Management

Acupuncture treatment of acute urinary retention caused by varicella-zoster virus through by combining the mechanism of sacral neuromodulation: A rare case report

Meningitis-retention syndrome: a review and update of an unrecognized clinical condition

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