title: Meningitis retention syndrome.
abstract: A 50-year-old Caucasian woman presented with signs and symptoms of meningitis preceded by a 3 day history of flu-like symptoms and progressive difficulty with urination. Cerebrospinal Fluid (CSF) analysis was consistent with aseptic meningitis. She was found to have a significant urinary retention secondary to atonic bladder. MRI of the brain and spine were normal and CSF-PCR (polymerase chain reaction) was positive for HSV-2. Urinary retention in the context of meningitis and CSF pleocytosis is known as Meningitis Retention Syndrome (MRS). MRS is a rare but important complication of meningitis most commonly associated with HSV-2. Involvement of central pathways may have a role in the pathogenesis of MRS but this is poorly documented. MRS is different from Elsberg syndrome wherein patients display features of lumbosacral polyradiculitis or radiculomyelitis. Early treatment with antiviral therapy was associated with a favorable outcome in our patient.
authors.affiliation: Department of Internal Medicine, University of Pittsburgh Medical Centre-McKeesport Hospital, McKeesport, PA, USA.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Krishna
authors.forename: Pavan
authors.initials: P
authors.lastname: Devulapally
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ghobrial
keywords: Elsberg syndrome; acyclovir; aseptic meningitis; atonic bladder; herpes simplex 2 virus infection; polyradiculitis; radiculomyelitis