From the Research
Diagnosis of Posterior Reversible Encephalopathy Syndrome (PRES) with Concurrent Leptospirosis
The diagnosis for a 12-year-old female patient with Posterior Reversible Encephalopathy Syndrome (PRES) and concurrent Leptospirosis, presenting with fever, seizures, hypertension, and bilateral occipital hypoattenuating lesions on computed tomography (CT) scan of the brain can be based on the following:
- Clinical presentation: The patient's symptoms such as fever, seizures, hypertension, and visual disturbances are consistent with PRES 1, 2, 3, 4.
- Imaging findings: The bilateral occipital hypoattenuating lesions on CT scan of the brain are characteristic of PRES 1, 2, 4.
- Association with systemic conditions: PRES is often associated with systemic conditions such as hypertension, infection, and sepsis 2, 3, 4.
- Leptospirosis as a potential trigger: While there is no direct evidence in the provided studies linking Leptospirosis to PRES, the infection can cause systemic inflammation and hypertension, which are known risk factors for PRES 3.
Key Considerations
- Prompt recognition and treatment of PRES are crucial to prevent permanent vision loss and improve outcomes 1, 2, 4.
- Control of blood pressure, antiepileptic therapy, and management of hydroelectrolytic and acid-base disorders are essential components of treatment 2, 4.
- Magnetic resonance imaging (MRI) with diffusion of molecules is the gold standard for diagnosis, but CT scan can also be used to support the diagnosis 2, 4.