An atypical herpes zoster case presenting with urinary tract irritation as the initial symptom

Bladder symptoms, an atypical manifestation of herpes zoster (HZ), usually occur after a vesicular eruption and can present as urinary retention or loss of sensation. We report a case of a patient who presented with urinary irritation preceding the skin lesion symptoms following uncomplicated COVID-19 infection.

A 67-year-old male presented with repeated episodes of frequent micturition. Initial examinations ruled out urinary infection or organic disorder, but revealed a diagnosis of COVID-19. Despite recovery from COVID-19, urinary irritation persisted, and the appearance of a skin rash in the groin area led to a diagnosis of herpes zoster. As herpes zoster resolved, the urinary symptoms gradually improved.

This case highlights an atypical presentation of herpes zoster with urinary symptoms preceding the skin rash. It underscores the importance of considering viral infections in patients with unexplained urinary symptoms to prevent diagnostic delays.