Posterior Reversible Encephalopathy Syndrome in a Pediatric Burn Patient: A Case Report

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 Candida tropicalis 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.