Posterior reversible encephalopathy syndrome in a child with leptospira-associated glomerulonephritis: the 3 P’S framework
Abstract
Posterior reversible encephalopathy syndrome (PRES) is an under-recognised cause of seizures in children, often obscured by concurrent infections. We report a girl in her middle childhood with recurrent seizures following a week of fever and flood exposure. Initial suspicion was leptospira encephalitis, supported by positive serology. However, progressive hypertension and CT brain findings confirmed PRES secondary to leptospira-associated acute glomerulonephritis. She improved with antihypertensives, antiepileptics and antibiotics, and was discharged seizure-free. This case highlights the risk of anchoring bias and introduces the '3 P's of PRES' framework-Pressure, Pattern and Pictures-for earlier recognition and management.
Fields of Study & Subjects
Neurological Complications and Syndromes
Leptospirosis research and findings
Moyamoya disease diagnosis and treatment
Publication details
- Journal / source
- BMJ Case Reports
- Volume
- 19
- Issue
- 1
- Pages
- e269939–e269939
- Publication date
- 1 January 2026
- Language
- EN