acyclovir and Urinary-Retention

Zona zoster infection is often associated with painful erythematous vesicular eruptions of the skin or mucous membranes. Varicella zoster virus which stays latent in the sensorial root ganglia causes zona zoster infection. The most recognized feature of zona zoster is the dermatomal distribution of vesicular rashes. In the present case report, we state an unusual presentation of sacral zona zoster with urinary retention, erectile dysfunction and meningitis.

Topics: Acyclovir; Adult; Antiviral Agents; Erectile Dysfunction; Ganglia, Spinal; Herpes Zoster; Humans; Male; Meningitis, Viral; Sacrum; Treatment Outcome; Urinary Catheterization; Urinary Retention

Topics: Acyclovir; Adult; Antiviral Agents; Fecal Incontinence; Female; Herpes Genitalis; Herpesvirus 2, Human; Humans; Paresthesia; Radiculopathy; Recovery of Function; Sacrum; Time Factors; Urinary Retention

Herpes simplex virus 1 and 2 infections affect up to 50 million people in the United States, with a natural history of recurrent viral shedding with or without recurrence of symptoms. Although many patients remain asymptomatic or with mild symptoms, a spectrum of rare but significant nervous system complications have been reported. Although urinary retention and constipation associated with genital herpesvirus infections is often attributed to painful genital ulcerations, herpesvirus-associated lumbosacral myeloradiculitis has been reported in adults. Here, we report an 18-year-old man with constipation, urinary retention, perineal paresthesias, and erectile dysfunction in the setting of a genital herpes infection. His workup was notable for a cerebrospinal fluid pleocytosis and MRI with enhancement of the cauda equina and nerve roots, all of which are consistent with sacral myeloradiculitis. The patient was treated with a 3-week course of intravenous acyclovir with complete resolution of symptoms. Pediatric practitioners should be aware of this complication of anogenital herpes simplex virus infection because appropriate diagnosis has implications for treatment delivery and duration.

Topics: Acyclovir; Adolescent; Antiviral Agents; Constipation; Herpes Genitalis; Humans; Male; Neuralgia; Paresthesia; Radiculopathy; Sacrum; Urinary Retention

A 75-year-old woman presented with new onset of confusion, intense episodic dizziness and formed visual hallucinations. Herpes simplex encephalitis and non-convulsive temporal lobe seizures were confirmed with cerebrospinal fluid (CSF) and electroencephalography testing. In addition, her hospital course was complicated by syndrome of inappropriate antidiuretic hormone secretion and atonic bladder contributing to an episode of urinary tract infection. After completing 3 weeks of acyclovir treatment, the patient became obtunded with right arm choreiform movements and persistent inflammatory CSF findings not attributable to persistent herpes simplex virus infection or other confounding factors. The patient responded to steroid treatment. Repeated autoimmune and paraneoplastic evaluations were negative. Both clinical (cognitive testing and atonic bladder) and CSF inflammatory finding improved in the follow-up period.

Topics: Acyclovir; Aged; Antiviral Agents; Chorea; Electroencephalography; Encephalitis; Encephalitis, Herpes Simplex; Female; Glucocorticoids; Humans; Inappropriate ADH Syndrome; Methylprednisolone; Seizures; Urinary Bladder, Underactive; Urinary Retention; Urinary Tract Infections

A 70-year-old man developed urinary retention in the early stages of herpes simplex virus (HSV) type-1 encephalitis. A nerve conduction study suggested latent myeloradiculitis. This is the first report of human herpes simplex virus-1 encephalitis followed by urinary retention at early stage from the onset like the Elsberg syndrome. Although relatively few similar cases have been reported, we consider that urinary retention is common in HSV-1 encephalitis, in which disturbances of consciousness usually require bladder catheterization from the onset. We further emphasize that urinary retention may occasionally occur in early stages of HSV-1 encephalitis, with a significant possibility of recovery.

Topics: Acyclovir; Aged; Antiviral Agents; Brain; Encephalitis, Herpes Simplex; Herpesvirus 1, Human; Humans; Male; Treatment Outcome; Urinary Retention

We report an unusual case of a 17-year-old young female presenting to the emergency department with varicella infection, acute urinary retention (AUR) and no other neurological deficits. An MRI of the spine confirmed the diagnosis of acute transverse myelitis. Positive serum IgG antibodies against varicella zoster virus (VZV) suggested a parainfectious aetiology. The patient eventually developed weakness and a sensory level from the third thoracic dermatome on day 2 of hospitalisation. Awareness that AUR can precede other neurological deficits in VZV transverse myelitis will prevent misdiagnosis and allow for the prompt treatment of this debilitating illness.

Topics: Acyclovir; Adolescent; Antiviral Agents; Diagnosis, Differential; Female; Herpesvirus 3, Human; Humans; Magnetic Resonance Imaging; Myelitis, Transverse; Thoracic Vertebrae; Urinary Retention; Varicella Zoster Virus Infection

We describe a case of urinary retention caused by viral sacral myeloradiculitis (Elsberg syndrome) that occurred one week after spinal anesthesia. The differential diagnosis of urinary retention after spinal anesthesia is discussed.. A 76-yr-old male patient presented for operative removal of a right testicular hydrocele under spinal anesthesia. Anesthesia and surgery were uneventful, and he was discharged on the fifth postoperative day. Two days after discharge, he developed intermittent anal pain and voiding difficulty and was readmitted to hospital on the tenth postoperative day. He subsequently developed urinary retention, incontinence of feces, and difficulty in defecation. Magnetic resonance imaging showed no epidural hematoma, abscess, or other lesions in the spinal column, cauda equina, or spinal cord. Neurological examination showed dysesthesia in the perineal region and loss of the anal reflex and bulbocavernosus response, which indicated sacral (S4-5) radiculopathy or a lesion of the conus of the spinal cord. A cerebrospinal analysis showed slight elevation of protein without pleocytosis. After neurologic consultation, herpetic sacral myeloradiculitis was suspected and intravenous acyclovir was administered along with large doses of methylprednisolone and immunoglobulin. The symptoms gradually resolved, and the difficulty in voiding resolved 19 days after initiation of the treatment. The patient was discharged 23 days after the start of the treatment without any other complications.. This case suggests that Elsberg syndrome is important in the differential diagnosis of urinary retention after spinal anesthesia and should be discriminated from other anesthesia-related complications.

Topics: Acyclovir; Aged; Anesthesia, Spinal; Diagnosis, Differential; Herpesviridae Infections; Humans; Immunoglobulins; Male; Methylprednisolone; Radiculopathy; Time Factors; Urinary Retention

Urinary retention is a common acute presentation for men in their later decades. Potential contributing pathologies are numerous. We report an unusual case of acute urinary retention requiring catheterisation secondary to sacral herpes zoster reactivation (S2-4) in an 88-year-old man with minimal preceding obstructive symptoms.

Topics: Acyclovir; Aged, 80 and over; Antiviral Agents; Herpes Zoster; Humans; Male; Urinary Catheterization; Urinary Retention

Topics: Acute Disease; Acyclovir; Antiviral Agents; Chickenpox; Child; Constipation; Herpesvirus 3, Human; Humans; Laxatives; Male; Urinary Catheterization; Urinary Retention

Topics: Acyclovir; Aged; Amines; Analgesics; Anti-Inflammatory Agents; Antiviral Agents; Cyclohexanecarboxylic Acids; Early Diagnosis; Female; Gabapentin; gamma-Aminobutyric Acid; Herpes Zoster; Humans; Magnetic Resonance Imaging; Methylprednisolone; Myelitis, Transverse; Neuralgia, Postherpetic; Paresthesia; Urinary Retention

Voiding dysfunction is a rare but important complication of lumbo-sacral herpes zoster. Although the symptoms are transient, the clinical impact on immunocompromised patients cannot be overlooked.. To clarify the time course of voiding dysfunction in herpes zoster, 13 herpes zoster patients with voiding dysfunction were retrospectively analyzed.. Of 13 patients, 12 had background disease, and six of these were hematopoietic malignancies; four of these patients were hematopoietic stem cell transplant (HSCT) recipients. Ten patients had sacral lesions, two had lumbar, and one had thoracic lesions. Interestingly, patients with severe rash, or with hematopoietic malignancy had later onset of urinary retention than did patients with mild skin symptoms (Mann-Whitney U analysis, P = 0.053) or with other background disease (P = 0.0082). Patients with severe skin rash also had longer durations (P = 0.035). In one case, acute urinary retention occurred as late as 19 days after the onset of skin rash.. In immune compromised subjects, attention should be paid to patients with herpes zoster in the lumbo-sacral area for late onset of acute urinary retention even after the resolution of skin symptoms.

Topics: Acyclovir; Adult; Aged; Aged, 80 and over; Antiviral Agents; Dysuria; Female; Hematologic Neoplasms; Herpes Zoster; Humans; Immunocompromised Host; Lumbosacral Region; Male; Middle Aged; Retrospective Studies; Urinary Catheterization; Urinary Retention

Topics: Acyclovir; Adult; Antiviral Agents; Female; Ganglia, Spinal; Herpes Simplex; Herpesvirus 2, Human; Humans; Hypesthesia; Leukocytosis; Myelitis; Radiculopathy; Sacrum; Syndrome; Urinary Retention

A 46-year-old male was admitted to our hospital with headache, high fever and subsequent consciousness disturbance. Spinal fluid examination intimated aseptic meningitis. Not only these symptoms but bladder dysfunction was presented. The patient was treated with conservative therapy and bladder dysfunction was resolved a month and a half later. We report a case of urinary retention secondary to aseptic meningitis and review the clinical presentation and treatment.

Topics: Acyclovir; Consciousness Disorders; Globins; Humans; Male; Meningitis, Aseptic; Middle Aged; Treatment Outcome; Urinary Retention

The antiviral effect of acyclovir elaidate in the female guinea pig model of genital herpes was investigated in a series of experiments. The antiherpesvirus effects of this novel compound, 9-(2'-[trans-9"-octadecenoyloxyl]ethoxymethyl)guanine (code no. P-4010), were studied in both primary and recurrent genital herpes in the female guinea pig, following oral gavage or intraperitoneal injection, with different formulations of the compound, and in comparison with acyclovir (ACV) or penciclovir (PCV). The results indicate that compound P-4010 has a greater capability than either ACV or PCV in reducing the clinical symptoms of primary genital herpes induced following the inoculation of herpes simplex virus type 2 (HSV-2) intravaginally into guinea pigs. In addition, the administration of P-4010 twice daily over a 10-day period by the intraperitoneal route (15 to 40 mg/kg of body weight/day) or by oral gavage (50 to 200 mg/kg/day), commencing 4 h subsequent to intravaginal HSV-2 infection, resulted in a degree of reduction in the incidence and severity of spontaneous, recurrent genital herpes in these animals. The findings are discussed in the light of the value and relevance of the female guinea pig model of genital herpes for the assessment of anti-herpes simplex virus compounds.

Topics: Acyclovir; Administration, Oral; Animals; Antiviral Agents; Female; Guanine; Guinea Pigs; Half-Life; Herpes Genitalis; Humans; Injections, Intraperitoneal; Oleic Acid; Oleic Acids; Recurrence; Urinary Retention; Vagina

Urinary retention is uncommon in patients with herpes zoster and anogenital herpes simplex. Seven patients (four men, three women) with a mean age of 68.1 years (range, 35-84) with urinary retention due to herpes zoster (n = 6) or anogenital herpes simplex (n = 1) were studied. Six patients had unilateral skin eruption in the saddle area (S2-4 dermatome) and one patient with herpes zoster had a skin lesion in the L4-5 dermatome. All patients had detrusor areflexia without bladder sensation, and two of them had inactive external sphincter on electromyography at presentation. Clean intermittent catheterization was performed, and voiding function was recovered in 4-6 weeks (average, 5.4) in all patients. Urodynamic study was repeated after recovery of micturition in three patients, and they returned to normal on cystometrography and external sphincter electromyography. Acute urinary retention associated with anogenital herpes infection has been thought to occur when the meninges or sacral spinal ganglia were involved, and, in conclusion, this condition may be considered to be reversible.

Topics: Acyclovir; Adult; Aged; Aged, 80 and over; Anal Canal; Antiviral Agents; Dermatitis; Female; Genitalia; Herpes Simplex; Herpes Zoster; Humans; Male; Middle Aged; Treatment Outcome; Urinary Retention; Urination; Urodynamics

Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Herpes Zoster; Humans; Male; Sacrococcygeal Region; Spinal Cord Diseases; Urinary Retention