# Meningitis-Retention Syndrome After Traumatic Subarachnoid Hemorrhage: A Case Report

## TL;DR

A 59-year-old man developed meningitis-retention syndrome after a traumatic brain injury, showing fever and urinary retention, and was successfully treated with antiviral therapy.

## Contribution

This case report highlights meningitis-retention syndrome as a rare but important differential diagnosis for fever and urinary retention post-trauma.

## Key findings

- The patient exhibited aseptic meningitis and urinary retention without other neurological issues, consistent with MRS.
- Antiviral treatment led to full recovery, with no further complications over 62 months.
- MRS may be underdiagnosed, emphasizing the need for early recognition in similar clinical presentations.

## Abstract

A 59-year-old male, who had been hospitalized for 13 days due to a traumatic subarachnoid hemorrhage, presented with a fever > 38ºC two days after discharge. He also experienced urinary retention five days after discharge. A lumbar puncture was performed on the sixth day after discharge because his Kernig’s sign became slightly positive. Cerebrospinal fluid analysis showed lymphocytic pleocytosis, while the etiological examination was negative. Finally, a diagnosis of meningitis-retention syndrome (MRS) was made. He was admitted to our department and received antiviral treatment for 14 days. He was discharged on the 23rd day, and the urinary catheter was removed about one month later. The patient’s clinical course has remained uneventful 62 months after discharge.

MRS is a para-infectious disease characterized by the combination of aseptic meningitis, cerebrospinal fluid pleocytosis, and acute urinary retention with no other neurological abnormalities. The actual prevalence of MRS is likely underestimated, making early diagnosis challenging. MRS should be considered in the differential diagnosis of patients presenting with fever and urinary retention.