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Case Reports in Medicine
Volume 2015, Article ID 185917, 4 pages
http://dx.doi.org/10.1155/2015/185917
Case Report

Dysuria, Urinary Retention, and Inguinal Pain as Manifestation of Sacral Bannwarth Syndrome

1Krankenanstalt Rudolfstiftung, Postfach 20, 1180 Vienna, Austria
2Private Office, Vienna, Austria
3Urological Department, Krankenanstalt Rudolfstiftung, Vienna, Austria
4Institute for Hygiene and Applied Immunology, Medical University of Vienna, Austria

Received 13 May 2015; Accepted 2 November 2015

Academic Editor: Stephen A. Klotz

Copyright © 2015 Josef Finsterer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Only few cases with sacral radiculitis due to infection with Borrelia burgdorferi leading to neurogenic urinary dysfunction have been reported. A 57-year-old male developed urethral pain and urinary retention, requiring permanent catheterization. Extensive urological investigations did not reveal a specific cause, which was why neurogenic bladder dysfunction was suspected. Neurologic exam revealed only mildly reduced tendon reflexes. Cerebral and spinal MRI were noninformative. CSF investigations, however, revealed pleocytosis, elevated protein, and antibodies against Borrelia burgdorferi. Intravenous ceftriaxone for three weeks resulted in immediate improvement of bladder dysfunction, with continuous decline of residual urine volume and continuous increase of spontaneous urine volume even after removal of the catheter and initiation of self-catheterization. Sacral radiculitis due to infection with Borrelia burgdorferi is a potential cause of detrusor areflexia and urethral, perineal, inguinal, and scrotal pain and may be misinterpreted as cystitis or urethritis. Ceftriaxone may result in progressive recovery of bladder dysfunction and pain. Neuroborreliosis may manifest exclusively as neurourological problem.