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与抗生素摄入相关的后部可逆性脑病综合征的罕见病因。

An Uncommon Cause of Posterior Reversible Encephalopathy Syndrome Related to Antibiotic Ingestion.

作者信息

El-Sheikh Souda, Memon Muhamad, Mujtaba Ahmed, Heena Humariya

机构信息

Neurology, King Fahad Medical City, Riyadh, SAU.

Internal Medicine, King Fahad Medical City, Riyadh, SAU.

出版信息

Cureus. 2018 Nov 3;10(11):e3540. doi: 10.7759/cureus.3540.

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state manifested with a unique computed tomography (CT) or magnetic resonance imaging (MRI) appearance. PRES is associated with different conditions, such as eclampsia, sepsis, organ transplantation, and drugs, especially immunosuppressive medications. Besides pharmacologic side effects, antibiotics can cause PRES as well. Here, we report a 37-year-old female from Saudi Arabia, presenting to the emergency department (ED) with a two-day history of fluctuations in consciousness level, headache, and blurring of vision. A generalized vesicular skin rash preceded the condition for one month; this was diagnosed as chicken pox and the patient received co-amoxiclav for a possible superadded bacterial infection. Besides clinical manifestations, the patient had radiological abnormalities, which were resolved following the withdrawal of causative antibiotics. Ascertaining the exact etiological cause of PRES is essential for diagnosing this reversible condition as these patients undergo a complete neurological recovery if the underlying cause is identified early.

摘要

后部可逆性脑病综合征(PRES)是一种具有独特计算机断层扫描(CT)或磁共振成像(MRI)表现的神经毒性状态。PRES与多种情况相关,如子痫、败血症、器官移植和药物,尤其是免疫抑制药物。除了药物副作用外,抗生素也可导致PRES。在此,我们报告一名来自沙特阿拉伯的37岁女性,因意识水平波动、头痛和视力模糊两天而就诊于急诊科。在该病情出现前一个月有全身性水疱性皮疹;诊断为水痘,患者因可能的叠加细菌感染接受了阿莫西林克拉维酸治疗。除临床表现外,患者还有影像学异常,停用致病抗生素后异常情况得以缓解。确定PRES的确切病因对于诊断这种可逆性疾病至关重要,因为如果能早期识别潜在病因,这些患者可实现完全的神经功能恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a22/6318117/efaa106d2045/cureus-0010-00000003540-i01.jpg

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