Meningitis retention syndrome: a case report

Urinary retention is a urologic emergency that is defined by an inability to voluntarily void urine, whichcan be acute or chronic. Benign inflammatory nervous diseases also cause acute urinary retention, inwhich patients lack apparent urethral outlet obstruction, but exhibit minor neurological and cerebrospinalfluid (CSF) abnormalities. The development of urinary retention in the context of meningitis and CSFpleocytosis without any lumbosacral radiculomyelitis is known as Meningitis Retention Syndrome(MRS). We report a 24-year-old male with complaints of urine dribbling, fever and also complete urinaryretention a few hours later and nausea/vomiting, headache and flank pain. The general and genitaliaexaminations, routine laboratory tests, diagnostic ultrasound, and brain MRI were normal. But HSV Ab(IgG) and PCR HSV were positive in CSF analysis. Finally, Urologist performed the Urodynamic studyand flaccid neurologic bladder was reported due the patient was treated with intravenous acyclovir 500mg, every eight hours, with the diagnosis of MRS. MRS is a rarely described clinical entity with featuresof meningitis and acute urinary retention. The most common cause of urinary retention is benign prostatichyperplasia. Other common causes include prostatitis, cystitis, urethritis, stones, and vulvovaginitis;receiving medications in the anticholinergic and alpha-adrenergic agonist classes; and cortical, spinal, orperipheral nerve lesions. Since MRS has a benign and self-remitting course, the effectiveness of immunetreatments (steroid pulse therapy) remains unclear, although such treatments may shorten the duration ofthe disease. Management of the acute urinary retention is necessary to avoid renal injury due tohydronephrosis.

Keywords:

urinary retention , Meningitis Retention Syndrome , MRS