Emergency Medical Minute Episode 973: Meningitis Retention Syndrome
Sep 8, 2025
Dive into the intriguing world of meningitis retention syndrome, a rare condition linking aseptic meningitis and urinary retention. The discussion reveals clinical presentations like fever and stiff neck, typically appearing with urinary issues about a week later. Explore the potential immune-mediated dysfunction that affects the central nervous system and the implications for treatment, including supportive care and bladder decompression. The episode features fascinating case studies that illustrate this unique phenomenon.
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Two Similar Cases In One Week
- Dr. Travis Barlock saw two patients in one week with meningitis who both developed acute urinary retention requiring bladder decompression.
- Both patients presented with fever, altered mental status, headache, neck stiffness, and very large post-void residuals around 1,500 cc.
Supportive Care And Prompt Bladder Decompression
- Manage patients with suspected MRS supportively and decompress the bladder promptly to relieve agitation and urinary retention.
- Recognize acute retention may arise about one week after initial meningeal symptoms and intervene with catheterization as needed.
Meningitis Retention Syndrome Defined
- Meningitis retention syndrome (MRS) pairs aseptic meningitis with acute urinary retention and is a distinct clinical entity.
- Studies suggest MRS occurs in roughly 8% of acute aseptic meningitis cases and may involve demyelination affecting urinary function.