Aseptic meningitis with urinary retention: a case report

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

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.

A Case Report: Aseptic Meningitis

Meningitis is an inflammation of the leptomeninges which surround the brain and the spinal cord. Depending on the organism, it is categorized as aseptic or bacterial meningitis. Cerebro-spinal fluid analyse and its culture are used for this categorization. Although it is thought to occur more frequent in paediatric population, 7.6 out of 100000 adults are affected by the disease. Some people may have sequels such as cognitive impairment, focal neurologic deficits and hearing loss. The mortality of viral meningitis is 4.5%, while it is 14.8% with bacterial meningitis. Headache, nausea and vomiting are the most seen complaints in the early stages of the disease. Because of that it can primarily be misdiagnosed with upper respiratory tract infections but also with other diseases. Therefore, some people may have a late diagnose. That increases the morbidity and the mortality. This case report, describes a patient who was diagnosed with aseptic meningitis. The patient presented herself to our clinic with the complaints of headache, intermittent fever, stomach ache, and voiding difficulty. Keywords: aseptic meningitis, Family Practice, vaccination

Sexually transmitted infections and their diagnoses: Bapedi experience

BACKGROUND

The global burden of sexually transmitted infections (STIs) is a major concern to the World Health Organization (WHO).

OBJECTIVE

To document STIs treated by Bapedi traditional healers and their methods of diagnoses in the Limpopo Province, South Africa.

METHODS

A semi-structured questionnaire with closed and open-ended questions was used to collect data from 34 traditional healers, during a face-to-face interview.

RESULTS

Five seemingly dissimilar STIs; gonorrhoea, chlamydia, HIV/AIDS, nta (Bapedi-terminology) and syphilis were identified as being treated by Bapedi traditional healers. With the exclusion of HIV/AIDS, all STIs are known by healers via their vernacular names. Not all of the recorded STIs are treated by all the questioned traditional healers. Generally, diagnosis of these infections was based primarily on the presentation of symptoms and certain behavioural traits; mostly unprotected sexual intercourse with multiple partners.

CONCLUSION

The current study concludes that Bapedi traditional healers play an important role in the treatment STIs in the Limpopo Province. Of concern is their diagnosis which is based primarily on the presentation of symptoms and behavioural traits, which are not always accurate indicators. Thus, to make their contribution to the treatment and management of STIs beneficial, they have to receive elementary training in diagnostic methods particularly for HIV/AIDS.

Meningitis-retention syndrome as a presentation of west nile virus meningitis

A 26-year-old previously healthy man presented with fever, urinary retention, nuchal rigidity, and hyperreflexia but with a clear sensorium. His initial spinal fluid results were consistent with aseptic meningitis from West Nile virus infection, and this was confirmed by serological studies on blood and cerebrospinal fluid. Computed tomography and magnetic resonance imaging studies were unremarkable. He received supportive care and urinary catheterization to prevent bladder injury from overdistension. He was discharged home without recurrence of urinary retention after five days of hospitalization. Therefore, this case report describes the first case of West Nile virus meningitis in a patient with the meningitis-retention syndrome.

Acute urinary retention secondary to Epstein-Barr virus infection in a pediatric patient: a case report and review of causes of acute urinary retention in children

We present the case of a 12-year-old boy with acute urinary retention presumed secondary to Epstein-Barr virus infection. Workup revealed an atonic bladder, which was refractory to medical management. The patient subsequently developed axillary lymphadenopathy, and the biopsy specimen was consistent with Epstein-Barr virus. In addition to presenting this patient with acute urinary retention secondary to EBV infection, we review the causes of acute urinary retention in children, with a focus on viral etiologies.