Shouri Shishir, Sharma Jignesh, Vt Aditya, Kumar Amber, Bhatt Girish
Pediatrics, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
Pediatric Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
Cureus. 2025 Aug 23;17(8):e90792. doi: 10.7759/cureus.90792. eCollection 2025 Aug.
Posterior reversible encephalopathy syndrome (PRES) is a rare clinico-radiological condition characterized by convulsions, headache, visual disturbances, and altered consciousness. PRES is often associated with immunosuppressive treatment, autoimmune disorders, hypertension, and renal illness, but it is rarely reported in pediatric burns. We report a four-year-old boy who presented with a history of hot water burns that affected 20% of his total body surface area (TBSA). He subsequently experienced right-sided hemifocal seizures, right hemiparesis, and a persistent fever three months after injury. MRI Brain revealed bilateral parieto-occipital hyperintensities and microhemorrhages consistent with PRES. Central line-associated bloodstream infection (CLABSI) with and hypertension were identified as the major contributing factors. Antiepileptics, antihypertensives, antifungals, nutritional rehabilitation, and skin grafting were all part of the management. Symptoms resolved within two weeks, and the patient was discharged without neurological deficits. This case underscores the importance of maintaining a heightened level of clinical suspicion for PRES in pediatric burn patients presenting with neurological symptoms. Reversing neurological impairments and achieving positive results depend on early detection, neuroimaging, and timely treatment of underlying triggers, which include infections and hypertension. The paper contributes to the limited literature on pediatric burn-related PRES, emphasizing the importance of multidisciplinary care and clinical monitoring in resource-limited settings.
后部可逆性脑病综合征(PRES)是一种罕见的临床影像学病症,其特征为惊厥、头痛、视觉障碍和意识改变。PRES常与免疫抑制治疗、自身免疫性疾病、高血压和肾脏疾病相关,但在小儿烧伤中鲜有报道。我们报告了一名4岁男孩,他有热水烫伤病史,烫伤面积占全身表面积(TBSA)的20%。受伤三个月后,他出现了右侧半侧惊厥、右侧偏瘫和持续发热。脑部磁共振成像(MRI)显示双侧顶枕叶高信号和微出血,符合PRES表现。已确定中心静脉导管相关血流感染(CLABSI)和高血压是主要促成因素。抗癫痫药、抗高血压药、抗真菌药、营养康复和皮肤移植均为治疗措施的一部分。症状在两周内缓解,患者出院时无神经功能缺损。该病例强调了对于出现神经症状的小儿烧伤患者,提高对PRES临床怀疑度的重要性。逆转神经功能障碍并取得积极结果取决于早期检测、神经影像学检查以及对包括感染和高血压在内的潜在触发因素的及时治疗。本文为小儿烧伤相关PRES的有限文献做出了贡献,强调了在资源有限环境下多学科护理和临床监测的重要性。