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

BMC Infect Dis. 2021 Sep 23;21(1):996. doi: 10.1186/s12879-021-06692-6.

Abstract

Background: Meningitis retention syndrome (MRS) is a rare condition that presents with acute urinary retention as a complication of aseptic meningitis. Cases of MRS due to varicella zoster virus (VZV) infection without a rash are rare. We report the case of a patient who had no signs of meningitis or VZV infection, including a rash.

Case presentation: A 58-year-old man presented with dysesthesia of the lower limbs and acute urinary retention. He had fever but no rash and no signs of meningitis. He was diagnosed to have VZV infection based on the detection of VZV DNA in the cerebrospinal fluid. He responded satisfactorily to a course of intravenous acyclovir and experienced no sequelae during a 2-year follow-up period.

Conclusion: MRS due to aseptic meningitis of viral origin should be considered in the differential diagnosis of acute urinary retention even in the absence of specific signs and symptoms of meningitis or a suggestive rash.

Keywords: Acute urinary retention; Lower limb dysesthesia; Meningitis retention syndrome; Varicella zoster virus; Zoster sine herpete.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / therapeutic use
  • Antiviral Agents / therapeutic use
  • Exanthema*
  • Herpes Zoster* / drug therapy
  • Herpesvirus 3, Human
  • Humans
  • Male
  • Meningitis, Aseptic* / diagnosis
  • Meningitis, Aseptic* / drug therapy
  • Middle Aged

Substances

  • Antiviral Agents
  • Acyclovir