Aseptic Meningitis with Urinary Retention: A Case Report

Fotinie Ntziora,Aristidis Alevizopoulos,Konstantinos Stravodimos,Kostas Konstantopoulos,Sofia Kanellopoulou,Dimitrios Bougas

doi:10.1155/2011/741621

Fotinie Ntziora, Aristidis Alevizopoulos

Open Access

https://doi.org/10.1155/2011/741621

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Abstract

Introduction. Aseptic meningitis is serious inflammation of the meninges caused by agents including viruses, non-viral pathogens, non-infectious conditions and chemicals. Case Presentation. This study concerns the case of a 16-year-old healthy Greek female with persistent fever, mild headache and acute urinary retention, secondary to aseptic meningitis. Physical examination revealed no distinct signs of meningeal irritation. The urinary bladder was palpable, painless and over-distended. Serology carried out for common viruses was as follows: CMV IgG (−), CMV IgM (−), HSV IgG (−), HSV IgM (+), VZ IgG (+), VZ IgM (−), EBV IgG (−) and EBV IgM (+). During recovery in hospital, three trials of removing a urinary catheter were carried out; during the first two attempts the patient was unable to urinate and had a loss of bladder sensation. On the third attempt the patient had modest bladder perception but she left a post-voiding residual, and was instructed to perform bladder self-catheterization. Seven days after being discharged the patient underwent a full recovery. Conclusion. There are few reports concerning aseptic meningitis together with acute urinary retention. A number of these cases concern so-called “meningitis-retention syndrome,” which implies an underlying CNS mechanism, while others concerned an underlying peripheral nervous system mechanism.

Highlights

Aseptic meningitis is serious inflammation of the meninges caused by agents including viruses, non-viral pathogens, non-infectious conditions and chemicals
Aseptic meningitis is serious inflammation of the meninges caused by non-bacterial agents including viruses, non-viral pathogens, and non-infectious conditions such as systemic lupus erythematosus, leukemia, lymphoma, and nonsteroidal anti-inflammatory drugs (NSAIDs) and other chemicals
Patients can present with a variety of symptoms ranging from asymptomatic pleocytosis in the cerebrospinal fluid (CSF) to a serious neurological deficiency

Summary

Introduction

Aseptic meningitis is serious inflammation of the meninges caused by non-bacterial agents including viruses, non-viral pathogens, and non-infectious conditions such as systemic lupus erythematosus, leukemia, lymphoma, and nonsteroidal anti-inflammatory drugs (NSAIDs) and other chemicals. Enteroviruses are responsible for more than 90% of aseptic meningitis cases, during summer and autumn. Other viruses including flavivirus, herpesvirus, and mumps can cause meningitis [1]. In the majority of cases, patients are admitted with fever, headache, a stiff neck, nausea, and vomiting. Patients can present with a variety of symptoms ranging from asymptomatic pleocytosis in the cerebrospinal fluid (CSF) to a serious neurological deficiency. This paper presents the case of a young female patient with acute urinary retention secondary to aseptic meningitis. The combination of urinary retention and meningitis is described in the literature, but it is considered uncommon

Case Presentation

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