고령의 대상포진후 신경통 환자 치료 중 발생한 심한 하지 부종 증례 보고
Severe Lower Extremity Edema during the Post-herpetic Neuralgia Management in Old Age A case report
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Abstract
Herpes zoster (HZ), or shingles, is a common disease. For most patients skin healing and pain resolution occur within 3-4 weeks. However, pain can continue after the rash has healed. Herein, a case is presented in which acute urinary retention (AUR) occurred during post-herpetic neuralgia (PHN) treatment in an old aged patient. The patient was an 84-year-old man, who was evaluated due to reports of excruciating and burning pain secondary to HZ on the left thigh and knee area of 2 months duration. Initially, the symptoms of PHN were likely to respond well to the conventional combination of sympathetic blockade, anticonvulsants, antidepressants and opioids. However, after the administration of a mixed intravenous infusion of ketamine and midazolam, the patient experienced a sudden onset of AUR, with severe edema of both legs, which lasted 72 hours. Upon insertion of a Nelaton catheter, approximately 900 ml of clear, yellow urine were obtained, which resulted in a marked improvement of his discomfort. This case of acute transient urinary retention, associated with PHN management in old age, is reported.
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