ro13-9904 and Urinary-Retention

Progressive myelopathy, urinary retention and gait problems are rare presenting features of Lyme neuroborreliosis. A 30-year-old man had 11 months of urinary retention and 3 months of spastic paraparesis. MR scans of the brain and the spinal cord showed leptomeningeal thickening with contrast enhancement. Cerebrospinal fluid showed mononuclear pleocytosis, decreased glucose, increased protein and chemokine ligand 13, with intrathecal

Topics: Adult; Ceftriaxone; Doxycycline; Humans; Lyme Neuroborreliosis; Male; Paraparesis, Spastic; Urinary Retention

Topics: Administration, Intravenous; Adolescent; Anti-Bacterial Agents; Brain; Ceftriaxone; Central Nervous System Viral Diseases; Diagnosis, Differential; Diarrhea; Flushing; Guillain-Barre Syndrome; Headache; Humans; Immunoglobulins, Intravenous; Immunologic Factors; Irritable Mood; Lyme Neuroborreliosis; Magnetic Resonance Imaging; Male; Meningitis, Bacterial; Myelitis; Neck Pain; Paresthesia; Peroneal Neuropathies; Pneumonia, Bacterial; Reflex, Abnormal; Spinal Cord; Sweating; Urinary Retention; West Nile Fever

Acute urinary retention (AUR) in females is a rare condition (annual incidence 3-7/100,000/year). In the past AUR was considered to be of psychogenic origin. Today diagnostic tools have improved and aetiologic factors for AUR are more easily diagnosed and managed. Causes of AUR can be of infectious, pharmacological, neurological, anatomical, myopathic and functional origin. We report a case of a woman aged 34 who presented with AUR caused by Lyme borreliosis. The patient fully recovered after intravenous antibiotic treatment and micturition returned to the habitual condition.

Topics: Acute Disease; Adult; Anti-Bacterial Agents; Ceftriaxone; Female; Humans; Lyme Disease; Recovery of Function; Urinary Retention; Urodynamics

Ceftriaxone is known to cause biliary pseudolithiasis and, rarely, nephrolithiasis. When used in neonates receiving intravenous calcium, fatal lung and kidney calcifications occur. There is no satisfactory explanation for the pseudolithiasis, and the mechanism of stone formation remains unknown. Herein, we report a child with acute urinary retention (AUR) secondary to ceftriaxone therapy. The AUR developed on the second hospital day. The urinary excretion of uric acid was elevated. In retrospect, there was a positive paternal family history of gout and stones. A positive family history of gout or stones is a pointer to the possibility of AUR or urolithiasis in patients on treatment with ceftriaxone. If urinary symptoms develop, it is worth checking for crystalluria. This will avoid many unnecessary investigations and procedures.

Topics: Acute Disease; Anti-Bacterial Agents; Ceftriaxone; Child, Preschool; Humans; Male; Meningitis; Uric Acid; Urinary Retention

Abscess of the prostate has become increasingly rare due to modern antibiotics and a decreasing incidence of gonococcal infections. It is still difficult to diagnose the disorder on clinical grounds. Diagnosis is often made after Ultrasound examination. We report 2 cases of prostatic abscess and review etiopathogenic factors, clinical findings, diagnosis and treatment of this uncommon entity.

Topics: Abscess; Amikacin; Anti-Bacterial Agents; Ceftriaxone; Ciprofloxacin; Diagnosis, Differential; Dysuria; Humans; Male; Middle Aged; Prostate; Prostatic Diseases; Ultrasonography; Urinary Retention

Topics: Analgesia, Epidural; Anti-Bacterial Agents; Back Pain; Carcinoma, Renal Cell; Ceftriaxone; Fatal Outcome; Humans; Kidney Neoplasms; Male; Meningitis, Bacterial; Middle Aged; Palliative Care; Paraplegia; Urinary Retention

Several neurological manifestations of Lyme disease, both central and peripheral, have been described. Reported here is a case of acute transverse myelitis related to a Lyme neuroborreliosis that presented with isolated acute urinary retention and no lower-extremity impairment. This case, documented by urodynamic and electrophysiological investigations, partially resolved after 6 weeks of intravenous ceftriaxone, affording the removal of the indwelling catheter. Alpha blocker therapy was needed for 3 months, until the complete normalisation of urodynamic and electrophysiological records. This case study indicates that whenever urinary retention is encountered associated with acute transverse myelitis or alone, the patient should be investigated for Lyme disease.

Topics: Ceftriaxone; Cephalosporins; Humans; Lyme Disease; Male; Middle Aged; Myelitis, Transverse; Urinary Retention