A rare cause of acute ürinary retention: Meningitis-retention syndrome caused by Varicella Zoster virus

Ertuğrul Köse; Onur Kalaycı; Murat Gülşen

A rare cause of acute ürinary retention: Meningitis-retention syndrome caused by Varicella Zoster virus

Abstract

A 33-year-old male patient presented to the urology clinic with complaints of headache, fatigue, and acute urinary retention. Physical examination revealed paresthesia/hypoesthesia in the S3–S5 dermatomes and decreased anal sphincter reflex. Blood and urine studies were performed, with results within normal limits. No abnormalities were observed in the urinary system on abdominal computed tomography. Cranial magnetic resonance imaging showed meningeal thickening and contrast enhancement. Lumbar puncture results reported a positive varicella zoster virus DNA. After the diagnosis, he was given intravenous acyclovir, and the symptoms gradually improved.

Keywords

Supporting Institution

The authors did not receive support from any organization for the submitted work.

References

Macovei L, Zurek L. Ecology of antibiotic resistance genes: characterization of enterococci from houseflies collected in food settings. Appl Environ Microbiol. 2006 Jun;72(6):4028-35.
Zhou W, Zhou H, Sun Y, Gao S, Zhang Y, Cao X, et al. Characterization of clinical enterococci isolates, focusing on the vancomycin-resistant enterococci in a tertiary hospital in China: based on the data from 2013 to 2018. BMC Infect Dis. 2020;20(1):356.
Deng F, Yao C, Ke L, Chen M, Huang M, Wen J, et al. Emerging threat to antibiotic resistance: Impact of mycotoxin deoxynivalenol on gut microbiota and clonal expansion of extensively drug-resistant enterococci. Environ Int. 2025;197:109353.
Teferi A, Tamrat R, Fufa D, Gorems K, Diriba TA, Tadesse M. Intestinal colonisation of vancomycin-resistant enterococci among patients with cancer at Jimma University Medical Center, Ethiopia: A comparative cross-sectional study. J Glob Antimicrob Resist. 2025;41:144–150.
Zhao M, He S, Wen R, Li C, Chen X, Lin X, et al. Membrane vesicles derived from Enterococcus faecalis promote the co-transfer of important antibiotic resistance genes located on both plasmids and chromosomes. J Antimicrob Chemother. 2024 Feb 1;79(2):320-326.
Chen P, An B, Hu Y, Tao Y. 2,4-Bisphenol S triggers physiological changes, oxidative stress and lipidome alterations in Gram-positive Enterococcus faecalis at environmental concentrations. Environ Pollut. 2025 Feb 1;366:125475.
Said MS, Tirthani E, Lesho E. Enterococcus Infections. 2024 Feb 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025.
Schleifer KH. Transfer of Streptococcus faecalis and Streptococcus faecium to the Genus Enterococcus nom. rev. as Enterococcus faecalis comb. nov. and Enterococcus faecium comb. nov. Int J Syst Evol Microbiol. 1984;34(1):31– 34.

Yusuf-Omoloye NA, Adeyemi FM, Sule WF, Yusuf W, Ajigbewu OH, Adegbite-Badmus MK, et al. Culture-dependent and molecular characterization of Vancomycin-Resistant Enterococci from clinical, food, and water samples across Osun State, Southwest Nigeria. Sci Afr. 2023;21:e01813.
Masoumi Zavaryani S, Mirnejad R, Piranfar V, Moosazadeh Moghaddam M, Sajjadi N, Saeedi S. Assessment of Susceptibility to Five Common Antibiotics and Their Resistance Pattern in Clinical Enterococcus Isolates. Iran J Pathol. 2020 Spring;15(2):96-105.
Erdene E, Munkhjargal O, Batnasan G, Dorjbal E, Oidov B, Byambaa A. Evaluation of Liposome-Encapsulated Vancomycin Against Methicillin-Resistant Staphylococcus aureus. Biomedicines. 2025 Feb 6;13(2):378.
Eltayeb LB. Vancomycin‑resistant enterococci (VRE) isolated from hospitalized patients: Molecular characterization of the van B gene. J Adv Pharm Educ Res. 2022;12(3):87–92.
Courvalin P. Vancomycin resistance in gram-positive cocci. Clin Infect Dis. 2006 Jan 1;42 Suppl 1:S25-34.
Boudrioua A, Baëtz B, Desmadril S, Goulard C, Groo AC, Lombard C, et al. Lasso peptides sviceucin and siamycin I exhibit anti-virulence activity and restore vancomycin effectiveness in vancomycin-resistant pathogens. iScience. 2025 Jan 30;28(3):111922.
Sfaciotte RAP, Parussolo L, Melo FD, Schneider MF, da Costa UM, Schwarz DGG, et al. Vancomycin-resistant Enterococcus (VRE) isolates from dogs and cats in veterinary hospitals in Brazil. BMC Vet Res. 2025 Feb 25;21(1):99.
Fujii A, Kawada-Matsuo M, Le MN, Suzuki Y, Nishihama S, Shiba H, et al. Comprehensive analysis of bacteriocins produced by clinical enterococcal isolates and their antibacterial activity against enterococci including VRE. Sci Rep. 2025;15(1):4846.
Hota S, Patil SR, Mane PM. Enterococcus: Understanding Their Resistance Mechanisms, Therapeutic Challenges, and Emerging Threats. Cureus. 2025 Feb 25;17(2):e79628.
Huang C, Moradi S, Sholeh M, Tabaei FM, Lai T, Tan B, et al. Global trends in antimicrobial resistance of Enterococcus faecium: a systematic review and meta-analysis of clinical isolates. Front Pharmacol. 2025 Apr 7;16:1505674.
Facklam RR, Collins MD. Identification of Enterococcus species isolated from human infections by a conventional test scheme. J Clin Microbiol. 1989;27(4):731–734.
Saifi M, Dallal MS, Pourshafie MR, Eshraghian MR, Pourmand MR, Salari MH, et al. High Level Resistance of Enterococcus faecium and E. faecalis Isolates from Municipal Sewage Treatment Plants to Gentamicin. Iran J Public Health. 1970;37(1):103–107.
Khan SA, Nawaz MS, Khan AA, Hopper SL, Jones RA, Cerniglia CE. Molecular characterization of multidrug-resistant Enterococcus spp. from poultry and dairy farms: detection of virulence and vancomycin resistance gene markers by PCR. Mol Cell Probes. 2005 Feb;19(1):27-34.
Chang S, Sievert DM, Hageman JC, Boulton ML, Tenover FC, Downes FP, et al. Vancomycin-Resistant Staphylococcus aureus Investigative Team. Infection with vancomycin-resistant Staphylococcus aureus containing the vanA resistance gene. N Engl J Med. 2003 Apr 3;348(14):1342-7.
Fisher K, Phillips C. The ecology, epidemiology and virulence of Enterococcus. Microbiology (Reading). 2009 Jun;155(Pt 6):1749-1757.
Mohammadi F, Tabaraie B, Sadeghifard N, Ghafoorian S, Maleki A, Davoodian E, et al. Evaluation of drug resistance frequency among Enterococcus faecium and E. faecalis strains and detection of vanA/B genes in vancomycin resistance isolated by PCR method in Ilam and Kermanshah hospitals. Iran J Med Microbiol. 2011;5(1):14–18.
Shahraki S, Rabi Nezhad Mousavi M, Dahmarde B, Atashgah M. Molecular evaluation of vanA and vanB genes of enterococci isolates resistant to vancomycin and teicoplanin. J Gorgan Univ Med Sci. 2017;19(2):84–90.
Tacconelli E, Cataldo MA. Vancomycin-resistant enterococci (VRE): transmission and control. Int J Antimicrob Agents. 2008;31(2):99–106.
Sulaiman AM, Hussein SA, Husain VI. Detection of antibiotic resistance genes (CTX‑M, Van A and Van B) of Enterococcus faecalis isolated from children with bacteremia by RT‑PCR. Arch Razi Inst. 2023;78(1):73–77.
Hosseini F, Kargar M. Study of frequency of VanA, VanB and VanC1/C2 genes in vancomycin resistant enterococci strains isolated from hospitalized and non-hospitalized patients in south of Fars province. J Shahid Sadoughi Univ Med Sci. 2017;24(12):963–971.
Alatrouny AM, Amin MA, Shabana HS. Prevalence of vancomycin-resistant enterococci among patients with nosocomial infection in intensive care unit. Al-Azhar Med J. 2020;49(4):1955–1964.
Hammerum AM, Karstensen KT, Roer L, Kaya H, Lindegaard M, Porsbo LJ, et al. Surveillance of vancomycin-resistant enterococci reveals shift in dominating clusters from vanA to vanB Enterococcus faecium clusters, Denmark, 2015 to 2022. Euro Surveill. 2024;29(23):2300633.
Adeyemi FM, Yusuf NA, Adeboye RR, Oluwajide OO, Ako-Nai AK. Comparative Analysis of Prevalence and Antibiotic Resistance in Vancomycin‑Resistant Enterococcus from Clinical Samples – Demographics and Phenotypes. Avicenna J Clin Microbiol Infect. 2021;8(2):57–65.
Dadashi M, Sharifian P, Bostanshirin N, Hajikhani B, Bostanghadiri N, Khosravi-Dehaghi N, et al. The Global Prevalence of Daptomycin, Tigecycline, and Linezolid-Resistant Enterococcus faecalis and Enterococcus faecium Strains From Human Clinical Samples: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 2021 Sep 10;8:720647.
Ghalavand Z, Alebouyeh M, Ghanati K, Azimi L, Rashidan M. Genetic relatedness of the Enterococcus faecalis isolates in stool and urine samples of patients with community-acquired urinary tract infection. Gut Pathog. 2020 Sep 9;12:42.
Karna A, Baral R, Khanal B. Characterization of Clinical Isolates of Enterococci with Special Reference to Glycopeptide Susceptibility at a Tertiary Care Center of Eastern Nepal. Int J Microbiol. 2019 Jul 1;2019:7936156.
Goudarzi M, Mobarez AM, Peerayeh SN, Mirzaee MOHSEN. Prevalence of Multidrug Resistance in Enterococcus faecium Isolated from Patients and Environment of Hospitals in Lorestan Province, Iran. Qom Univ Med Sci J. 2018;12(5):71–78.
Moghimbeigi A, Moghimbeygi M, Dousti M, Kiani F, Sayehmiri F, Sadeghifard N, et al. Prevalence of vancomycin resistance among isolates of enterococci in Iran: a systematic review and meta-analysis. Adolesc Health Med Ther. 2018 Nov 15;9:177-188.

Details

Primary Language

English

Subjects

Urology

Journal Section

Case Report

Authors

Ertuğrul Köse ^*
0000-0002-5295-3327
Türkiye

Onur Kalaycı
0000-0002-6898-7564
Türkiye

Murat Gülşen
0000-0001-5371-0960
Türkiye

Publication Date

June 30, 2025

Submission Date

December 9, 2024

Acceptance Date

April 21, 2025

Published in Issue

Year 2025 Volume: 42 Number: 2

IZ

https://izlik.org/JA98NX69BS

Cite

RIS / Bibtex

APA

Köse, E., Kalaycı, O., & Gülşen, M. (2025). A rare cause of acute ürinary retention: Meningitis-retention syndrome caused by Varicella Zoster virus. Deneysel Ve Klinik Tıp Dergisi, 42(2), 219-221. https://izlik.org/JA98NX69BS

AMA

1.Köse E, Kalaycı O, Gülşen M. A rare cause of acute ürinary retention: Meningitis-retention syndrome caused by Varicella Zoster virus. J. Exp. Clin. Med. 2025;42(2):219-221. https://izlik.org/JA98NX69BS

Chicago

Köse, Ertuğrul, Onur Kalaycı, and Murat Gülşen. 2025. “A Rare Cause of Acute ürinary Retention: Meningitis-Retention Syndrome Caused by Varicella Zoster Virus”. Deneysel Ve Klinik Tıp Dergisi 42 (2): 219-21. https://izlik.org/JA98NX69BS.

EndNote

Köse E, Kalaycı O, Gülşen M (June 1, 2025) A rare cause of acute ürinary retention: Meningitis-retention syndrome caused by Varicella Zoster virus. Deneysel ve Klinik Tıp Dergisi 42 2 219–221.

IEEE

[1]E. Köse, O. Kalaycı, and M. Gülşen, “A rare cause of acute ürinary retention: Meningitis-retention syndrome caused by Varicella Zoster virus”, J. Exp. Clin. Med., vol. 42, no. 2, pp. 219–221, June 2025, [Online]. Available: https://izlik.org/JA98NX69BS

ISNAD

Köse, Ertuğrul - Kalaycı, Onur - Gülşen, Murat. “A Rare Cause of Acute ürinary Retention: Meningitis-Retention Syndrome Caused by Varicella Zoster Virus”. Deneysel ve Klinik Tıp Dergisi 42/2 (June 1, 2025): 219-221. https://izlik.org/JA98NX69BS.

JAMA

1.Köse E, Kalaycı O, Gülşen M. A rare cause of acute ürinary retention: Meningitis-retention syndrome caused by Varicella Zoster virus. J. Exp. Clin. Med. 2025;42:219–221.

MLA

Köse, Ertuğrul, et al. “A Rare Cause of Acute ürinary Retention: Meningitis-Retention Syndrome Caused by Varicella Zoster Virus”. Deneysel Ve Klinik Tıp Dergisi, vol. 42, no. 2, June 2025, pp. 219-21, https://izlik.org/JA98NX69BS.

Vancouver

1.Ertuğrul Köse, Onur Kalaycı, Murat Gülşen. A rare cause of acute ürinary retention: Meningitis-retention syndrome caused by Varicella Zoster virus. J. Exp. Clin. Med. [Internet]. 2025 Jun. 1;42(2):219-21. Available from: https://izlik.org/JA98NX69BS