Dengue Causing Posterior Reversible Encephalopathy Syndrome: A Case Report from India

Abstract

Background: Posterior reversible encephalopathy syndrome (PRES) is characterized by altered mental status, headaches, visual disturbances, and seizures and caused due edema affecting mainly the parietal and occipital lobes of the brain. This clinical entity is increasingly established due to improvements in radiological investigations. Patient’s Concern: We present a 22-year-old female with 9-month amenorrhea with altered sensorium; the noncontrast computed tomography head showed ill-defined hypodensities in the bilateral occipital and parietal region suggestive of the PRES. Intervention: The patient was managed immediately with an injection of levetiracetam with intravenous (IV) fluids, antibiotics, and IV steroids. The patient had gross improvement in the sensorium and vision within 24 h. The patient was discharged on the 10th day of admission with 100% recovery. Follow-ups at 2 and 4 weeks were uneventful. Lesson Learnt: Even dengue can cause PRES, so the clinical entity should be recognized as early as possible. The treatment should be initiated urgently; knowledge of this can easily prevent unnecessary morbidity and mortality with complete recovery.