A diagnosis of ES is rare and can present with a variety of clinical presentations. The most common presentation is as cauda equina syndrome, which includes symptoms of sensory impairment, saddle anesthesia, lower extremity weakness and bowel/urinary incontinence. It is usually associated with infectious causes such as SARS-CoV-2 , West Nile Virus , Varicella Zoster Virus (VZV) and Herpes Simplex Virus Type 2 (HSV-2), with HSV-2 being the predominate causative pathogen. in 2017 a diagnostic criteria was created by Savoldi, in which the diagnosis should be considered for individuals presenting with urinary retention or hesitancy. According to Savoldi 's criteria (2) , our patient' s diagnosis is "clinically probable", since he met the following criteria: A1, clinical symptoms and signs of cauda equina involvement, including urinary hesitancy or retention, bowel incontinence, or severe constipation; B1, time course indicating acute/subacute onset, no relapse, and progression over less than 3 months; B4, CSF pleocytosis.
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