SHM Converge Scientific Abstract ePoster Gallery-Herpes Zoster Infection: A Case of Neurogenic Bladder

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This case describes a 70-year-old man who developed acute urinary retention and neurogenic bladder after a herpes zoster (shingles) outbreak. Herpes zoster is caused by reactivation of varicella zoster virus and typically presents as a painful, unilateral vesicular rash in a dermatomal distribution. When sacral dermatomes are involved, the infection can impair parasympathetic bladder function, leading to urinary retention, incontinence, or detrusor paralysis.<br /><br />The patient presented with abdominal pain, distention, constipation, and difficulty urinating one week after developing a painful vesicular rash on his abdomen and lower back. On evaluation, he had severe acute kidney injury with an elevated creatinine, but no evidence of urinary tract infection or other infectious cause. CT imaging showed marked bladder distention with mild bilateral hydroureteronephrosis. Placement of an indwelling catheter drained more than 5 liters of urine, which resolved the kidney injury. However, he failed a subsequent voiding trial and was discharged with a catheter and urology follow-up.<br /><br />The report emphasizes that urinary retention is a rare but important complication of herpes zoster, especially when lumbosacral or sacral dermatomes are affected. Most cases are temporary and improve over weeks to months with supportive care, including bladder catheterization and treatment of shingles. Clinicians should consider this diagnosis in patients with sacral zoster who develop urinary symptoms, as early recognition can prevent complications and improve quality of life.

Asset Subtitle

Fadumo Warsame

Meta Tag

Author List Fadumo Warsame, Guneesh Uberoi

Category Clinical Vignettes

Concept Herpes Zoster

Concept Acute Urinary Retention

Concept Varicella-Zoster Virus

Concept Neurogenic Bladder

Concept Catheterization

Distinguished Non-Finalist

Presenter Organization Emory

Presenting Author Fadumo Warsame

Track Adult

Keywords

herpes zoster

shingles

urinary retention

neurogenic bladder

sacral dermatomes

varicella zoster virus

acute kidney injury

hydroureteronephrosis

bladder catheterization

detrusor paralysis

Herpes Zoster

Acute Urinary Retention

Varicella-Zoster Virus

Neurogenic Bladder

Catheterization