A case of a cysto-rectal disorder caused by herpes zoster in the sacral spinal cord region

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  • 仙髄領域に発症した帯状疱疹による 膀胱直腸障害の1例

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Abstract

We report the case of a79-year-old woman with herpes zoster in the sacral medullary region complicated by a cysto-rectal disorder, which resolved spontaneously after four weeks of symptomatic treatment. For two years, the patient had been on peritoneal dialysis for end-stage renal failure due to immunoglobulin A nephropathy. One week before the skin rash appeared, her appetite decreased, weight decreased by 2kg, and urine output decreased. She was diagnosed with herpes zoster and prescribed amenamevir and mecobalamine. The next day, she experienced numbness in the right lower extremity and was admitted to our hospital. The skin rash crusted over within two weeks. However, following urinary incontinence on the ninth hospitalization day, she was diagnosed with neurogenic bladder secondary to herpes zoster. Treatment comprised intermittent urinary drainage and a course of urapidil and bethanechol ; the urinary drainage requirement subsided within four weeks of onset. Defecation disorder resolved with symptomatic treatment within two weeks. Herpes zoster of the buttocks can lead to bladder and rectal problems, as in this case. Furthermore, diagnosis in our case was made difficult by a chronically low urine output due to end-stage renal failure and dehydration due to a poor diet.

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