Akiyuki Hiraga1, Satoshi Kuwabara2. 1. Department of Neurology, Chiba Rosai Hospital, Chiba, Japan. Electronic address: hiragaa@yahoo.co.jp. 2. Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Abstract
BACKGROUND: Meningitis-retention syndrome (MRS) is a peculiar combination of aseptic meningitis (AM) and acute urinary retention without other neurological symptoms. MRS has not been well recognised, and the prevalence of MRS in patients with AM is unknown. OBJECTIVE: To investigate the frequency and clinical features of MRS. METHODS: Clinical and laboratory features of patients with MRS who were consecutively admitted to the Chiba Rosai Hospital between 2009 and 2017. RESULTS: Of the 37 patients with AM, MRS was observed in three (8%). In MRS patients, the mean latency between the onset of meningeal symptoms (headache and/or fever) and the three clinical course milestones (the onset of voiding difficulty, urinary retention and recovery of no residual urine volume) were 8, 9.3 and 18 days, respectively. Patients with MRS frequently showed elevated cerebrospinal fluid adenosine deaminase levels and decreased cerebrospinal fluid/serum glucose ratios. All patients with MRS recovered without a specific treatment, and the mean hospital stay was 18 days. CONCLUSIONS: MRS may be more common than is generally considered. The long-term prognosis of MRS was good, and it was a self-limiting condition. However, it is likely to be underreported or misdiagnosed. Therefore, it is important to recognise that patients with AM may have MRS.
BACKGROUND:Meningitis-retention syndrome (MRS) is a peculiar combination of aseptic meningitis (AM) and acute urinary retention without other neurological symptoms. MRS has not been well recognised, and the prevalence of MRS in patients with AM is unknown. OBJECTIVE: To investigate the frequency and clinical features of MRS. METHODS: Clinical and laboratory features of patients with MRS who were consecutively admitted to the Chiba Rosai Hospital between 2009 and 2017. RESULTS: Of the 37 patients with AM, MRS was observed in three (8%). In MRSpatients, the mean latency between the onset of meningeal symptoms (headache and/or fever) and the three clinical course milestones (the onset of voiding difficulty, urinary retention and recovery of no residual urine volume) were 8, 9.3 and 18 days, respectively. Patients with MRS frequently showed elevated cerebrospinal fluid adenosine deaminase levels and decreased cerebrospinal fluid/serum glucose ratios. All patients with MRS recovered without a specific treatment, and the mean hospital stay was 18 days. CONCLUSIONS:MRS may be more common than is generally considered. The long-term prognosis of MRS was good, and it was a self-limiting condition. However, it is likely to be underreported or misdiagnosed. Therefore, it is important to recognise that patients with AM may have MRS.