Herpes zoster‐associated voiding dysfunction in hematopoietic malignancy patients

• Published in: International journal of dermatology 2008-01, Vol.47 (1), p.36-39
• Main Authors: Imafuku, Shinichi, Takahara, Masakazu, Uenotsuchi, Takeshi, Iwato, Koji, Furue, Masutaka
• Format: Article
• Language: English
• Subjects: Acyclovir - administration & dosage; Adult; Aged; Aged, 80 and over; Antiviral Agents - administration & dosage; Biological and medical sciences; Dermatology; Dysuria - etiology; Female; Hematologic Neoplasms - complications; Herpes Zoster - complications; Herpes Zoster - drug therapy; Herpes Zoster - immunology; Human viral diseases; Humans; Immunocompromised Host; Infectious diseases; Lumbosacral Region - pathology; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Retrospective Studies; Urinary Catheterization; Urinary Retention - etiology; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye
• ISSN: 0011-9059; 1365-4632
• DOI: 10.1111/j.1365-4632.2007.03548.x

Background  Voiding dysfunction is a rare but important complication of lumbo‐sacral herpes zoster. Although the symptoms are transient, the clinical impact on immunocompromised patients cannot be overlooked. Methods  To clarify the time course of voiding dysfunction in herpes zoster, 13 herpes zoster patients with voiding dysfunction were retrospectively analyzed. Results  Of 13 patients, 12 had background disease, and six of these were hematopoietic malignancies; four of these patients were hematopoietic stem cell transplant (HSCT) recipients. Ten patients had sacral lesions, two had lumbar, and one had thoracic lesions. Interestingly, patients with severe rash, or with hematopoietic malignancy had later onset of urinary retention than did patients with mild skin symptoms (Mann–Whitney U analysis, P = 0.053) or with other background disease (P = 0.0082). Patients with severe skin rash also had longer durations (P = 0.035). In one case, acute urinary retention occurred as late as 19 days after the onset of skin rash. Conclusions  In immune compromised subjects, attention should be paid to patients with herpes zoster in the lumbo‐sacral area for late onset of acute urinary retention even after the resolution of skin symptoms.