Ntziora Fotinie, Alevizopoulos Aristidis, Konstantopoulos Kostas, Kanellopoulou Sofia, Bougas Dimitrios, Stravodimos Konstantinos
1st Academic Department of Medicine, Laiko General Hospital, Medical School, University of Athens, 11527 Athens, Greece.
Case Rep Med. 2011;2011:741621. doi: 10.1155/2011/741621. Epub 2011 Oct 30.
Introduction. Aseptic meningitis is serious inflammation of the meninges caused by agents including viruses, non-viral pathogens, non-infectious conditions and chemicals. Case Presentation. This study concerns the case of a 16-year-old healthy Greek female with persistent fever, mild headache and acute urinary retention, secondary to aseptic meningitis. Physical examination revealed no distinct signs of meningeal irritation. The urinary bladder was palpable, painless and over-distended. Serology carried out for common viruses was as follows: CMV IgG (-), CMV IgM (-), HSV IgG (-), HSV IgM (+), VZ IgG (+), VZ IgM (-), EBV IgG (-) and EBV IgM (+). During recovery in hospital, three trials of removing a urinary catheter were carried out; during the first two attempts the patient was unable to urinate and had a loss of bladder sensation. On the third attempt the patient had modest bladder perception but she left a post-voiding residual, and was instructed to perform bladder self-catheterization. Seven days after being discharged the patient underwent a full recovery. Conclusion. There are few reports concerning aseptic meningitis together with acute urinary retention. A number of these cases concern so-called "meningitis-retention syndrome," which implies an underlying CNS mechanism, while others concerned an underlying peripheral nervous system mechanism.
引言。无菌性脑膜炎是由病毒、非病毒病原体、非感染性疾病和化学物质等因素引起的脑膜严重炎症。病例报告。本研究涉及一名16岁健康希腊女性，继发于无菌性脑膜炎，出现持续发热、轻度头痛和急性尿潴留。体格检查未发现明显的脑膜刺激征。膀胱可触及，无痛且过度膨胀。对常见病毒进行的血清学检查结果如下：巨细胞病毒IgG（-），巨细胞病毒IgM（-），单纯疱疹病毒IgG（-），单纯疱疹病毒IgM（+），水痘-带状疱疹病毒IgG（+），水痘-带状疱疹病毒IgM（-），EB病毒IgG（-）和EB病毒IgM（+）。在住院康复期间，进行了三次拔除导尿管的尝试；在前两次尝试中，患者无法排尿且膀胱感觉丧失。第三次尝试时，患者膀胱感觉有所恢复，但仍有残余尿量，并被指导进行膀胱自我导尿。出院七天后，患者完全康复。结论。关于无菌性脑膜炎合并急性尿潴留的报道较少。其中一些病例涉及所谓的“脑膜炎-潴留综合征”，这意味着存在潜在的中枢神经系统机制，而其他病例则涉及潜在的周围神经系统机制。
