レプトスピラ関連糸球体腎炎を伴う小児の後部可逆性脳症候群：3つのPフレームワーク

Posterior reversible encephalopathy syndrome (PRES) is an under-recognised cause of seizures in children, often obscured by concurrent infections. We report a girl in her middle childhood with recurrent seizures following a week of fever and flood exposure. Initial suspicion was leptospira encephalitis, supported by positive serology. However, progressive hypertension and CT brain findings confirmed PRES secondary to leptospira-associated acute glomerulonephritis. She improved with antihypertensives, antiepileptics and antibiotics, and was discharged seizure-free. This case highlights the risk of anchoring bias and introduces the '3 P's of PRES' framework-Pressure, Pattern and Pictures-for earlier recognition and management.