A Pediatric Case of Urinary Retention Caused by Shingles on the Buttocks

Herpes zoster, also called shingles, is caused by the varicella zoster virus (VZV), which can become active again after lying dormant in nerve cells following chickenpox. Cases of herpes zoster affecting the buttocks in children that lead to urinary retention are rare. This report details a notable case of a 10-year-old girl who experienced urinary retention for nine days before she was hospitalized. Her medical history included chickenpox at approximately one year of age. Five days before the presentation, she visited a clinic where she was advised to undergo urinalysis and was prescribed antibiotics, but her condition did not improve. Around that time, the patient developed a rash on her buttocks and decided to monitor it without further treatment. As her symptoms worsened, she returned for a second urinalysis and was administered antibiotics again without relief. Upon admission, she developed a flat rash near her right buttock, raising suspicion of herpes zoster. Along with urinary issues, she complained of lower abdominal pain, and ultrasonography showed that approximately 800 mL of urine was retained in her bladder. A urinary catheter was inserted, and the patient was treated with valacyclovir. By day 4, the catheter was removed, and the shingles lesions began to crust. The patient was discharged on day 7 with no recurrence. Shingles-related urinary retention in children is extremely rare, making diagnosis challenging owing to the diverse symptoms and rash locations. This case highlights the importance of awareness of such presentations.