KEY POINTS

  • Four days before being hospitalized, the man faced difficulty emptying his bladder
  • CT scan revealed he had a large amount of fluid accumulated in the abdomen and pelvis
  • His heart rate, blood pressure and breathing rate were all found to be abnormally high
  • On emptying the urine mixed with blood, a nearly 0.8-inch tear in the bladder was detected

In the first ever clinically documented case, a man's urinary bladder reportedly ruptured due to a shingles infection.

According to the case report, published in the journal Infection and Drug Resistance, the 77-year-old man was being treated with antiviral and pain-relieving medications for his shingles infection a week before he was admitted to the emergency department.

Four days before being admitted to the hospital, the man faced difficulty in emptying his bladder. On examination, the doctors found that the area below his stomach was "distended and painful."

Additionally, the patient's heart rate, blood pressure, and breathing rate were found to be abnormally high.

A computed tomography (CT) scan revealed a large amount of fluid accumulated in his abdomen and pelvis. The doctors suspected a "bladder breach."

The patient was then shifted to the intensive care unit where a catheter was placed to clear the urine retained in the body. With the catheter, urine mixed with blood continuously flowed out from the tube for three hours.

Once the urine was emptied, doctors examined the man's bladder and found a tear in the organ that was nearly 0.8 inches in size, according to LiveScience.

The doctors repaired the man's bladder with the help of surgery. The patient was in the hospital for several weeks to ensure complete recovery. "The patient regained complete bladder function after undergoing surgery to repair the bladder and treatment with antiviral drugs," the team reported.

This case brought to light a very rare consequence of shingles infection.

Shingles infection, also called herpes zoster, is caused by the varicella-zoster virus which is also responsible for chickenpox. After entering the body during the pox infection, the virus lies dormant in certain nerves.

In some cases, the virus can be "reactivated" later in life and emerge as a shingles infection. Painful fluid-filled blisters are characteristic of a shingles infection.

Urine retention is a rare consequence of shingles infection. The doctors believe that inability to pass urine caused extreme pressure on the man's bladder, leading to the rupture. Other potential factors that could lead to urinary retention, such as an obstruction of the urinary tract or the use of certain medications, were ruled out by the team.

"The risk of herpes zoster-associated urinary system dysfunction cannot be ignored," the doctors wrote. "Urgent intervention is required for the acute urinary retention caused by herpes zoster infection in the sacral area."

The man also had a history of type 2 diabetes which could have contributed to urine retention, doctors said, noting that diabetes damages the nerves causing the patient to lose some ability to sense when their bladder is full and to empty it properly.

Intensive Care Unit (ICU) for COVID-19 patients at Alexandrovska hospital
Reuters