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Reading: Postoperative posterior reversible encephalopathy in Escherichia coli bacteremia

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Case Report

Postoperative posterior reversible encephalopathy in Escherichia coli bacteremia

Authors:

Rita W. Rehana ,

Department of General Surgery, Louis A. Weiss Memorial Hospital, 4646 NorthMarine Drive, Chicago, IL 60640, US
About Rita W.

BS

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Rahim A. Jiwani,

Department of Internal Medicine, Louis A. Weiss Memorial Hospital, Chicago, IL, US
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BS

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Adriana G. Olariu

Department of Pulmonary and Critical Care, University of North Carolina, Chapel Hill, NC, US
About Adriana G.

MD

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Abstract

Posterior reversible encephalopathy syndrome (PRES) is clinically characterized by headaches, decreased cognition, cortical vision loss, confusion, seizures and it is associated with characteristic radiologic findings. The currently known etiologies of PRES include: hypertension, renal failure, immunomodulating drugs, infective processes, and shock. The relative infrequency combined with the broad differential diagnosis makes PRES a diagnostic challenge. The best imaging for detecting PRES is magnetic resonance imaging. Computerized tomography/magnetic resonance imaging of PRES shows specific damage to bilateral parietal and occipital lobes, specifically the cortical and subcortical regions, depicting vasogenic edema. The extent of brain damage and duration of onset without diagnosis essentially determines the “reversible” effects. Therefore, the absence of the more common etiologies in this case of PRES highlights the diagnostic value of maintaining a broad clinical differential diagnosis when evaluating a patient with new-onset postoperative seizures to correctly guide diagnostic work up and treatment. We describe the first case of PRES in the setting of acute lower gastrointestinal bleeding, Escherichia coli bacteremia and recent general anesthesia.

How to Cite: Rehana RW, Jiwani RA, Olariu AG. Postoperative posterior reversible encephalopathy in Escherichia coli bacteremia. International Journal of Surgery: Oncology. 2018;3(2):e57. DOI: http://doi.org/10.1097/IJ9.0000000000000057
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Published on 02 Jan 2018.
Peer Reviewed

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