Herpes zoster-associated acute urinary retention in immunocompetent patient

Abstract

Herpes zoster-associated urinary retention is an uncommon event related to virus infection of the S2-S4 dermatome. The possible major reasons are ipsilateral hemicystitis, neuritis-induced or myelitis-associated virus infection. We report a case of a 65-year-old immunocompetent female patient who presented an acute urinary retention after four days under treatment with valacyclovir for gluteal herpes zoster. The patient had to use a vesical catheter, was treated with antibiotics and corticosteroids and fully recovered after eight weeks.

Herpes-Zoster-Associated Voiding Dysfunction in an Immunocompromised Patient

“…Herpes zoster is an uncommon cause of voiding dysfunction. It was first reported by Davidsohn in 1890 [6,7]. In 2002, Chen et al reviewed 423 cases of herpes zoster in a large university-affiliated medical center in Taiwan, finding 17 (4.02%) with voiding dysfunction attributed to herpes zoster.…”

“…It typically presents as acute urinary retention four to nineteen days after the skin rash, and the clinical course can last four to eight weeks. Finally, myelitis-associated voiding dysfunction (spastic bladder) is less prevalent; the majority of patients achieve complete recovery after a few weeks [6,8,9].…”

Emphysematous cystitis associated with voiding dysfunction from herpes zoster

“…1,2 In neuritis, the varicella-zoster virus in the unilateral sacral dorsal root ganglion spreads into the bilateral sacral motor nerves, interrupting the bilateral detrusor reflex, which manifests as an underactive bladder, as in this patient. 1,2 In myelitis, suprasacral spinal cord inflammation causes a spastic bladder. 1,2 Emphysematous cystitis is an uncommon form of urinary tract infection that may be complicated by sepsis and is characterized by gas formation within the bladder wall and lumen.…”

“…1,2 Cystitis involves direct invasion of the bladder wall by the varicella-zoster virus, resulting in dysuria and increased urinary frequency or retention. 1,2 In neuritis, the varicella-zoster virus in the unilateral sacral dorsal root ganglion spreads into the bilateral sacral motor nerves, interrupting the bilateral detrusor reflex, which manifests as an underactive bladder, as in this patient. 1,2 In myelitis, suprasacral spinal cord inflammation causes a spastic bladder.…”

“…1,2 In myelitis, suprasacral spinal cord inflammation causes a spastic bladder. 1,2 Emphysematous cystitis is an uncommon form of urinary tract infection that may be complicated by sepsis and is characterized by gas formation within the bladder wall and lumen. Older women and patients with diabetes mellitus, obstructive uropathy and neurogenic bladder are predisposed to emphysematous cystitis.…”