Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 16, 2016; 4(4): 103-107
Published online Apr 16, 2016. doi: 10.12998/wjcc.v4.i4.103
Posterior reversible encephalopathy syndrome following sepsis in a Crohn’s disease patient: A case report
Ioannis Papaconstantinou, Dionysios S Mantzos, Eirini Pantiora, Marios K Tasoulis, Sofia Vassilopoulou, Gerassimos Mantzaris
Ioannis Papaconstantinou, Dionysios S Mantzos, Eirini Pantiora, Marios K Tasoulis, 2nd Department of Surgery, Aretaieio Hospital, Medical School, University of Athens, 11528 Athens, Greece
Sofia Vassilopoulou, 1st Department of Neurology, Eginition Hospital, Medical School, University of Athens, 11528 Athens, Greece
Gerassimos Mantzaris, 1st Gastroenterology Department, Evangelismos Hospital, 10676 Athens, Greece
Author contributions: Papaconstantinou I, Mantzos DS and Pantiora E did the study design, literature review and drafting of the manuscript; Tasoulis MK, Vassilopoulou S and Mantzaris G provided additional information and contributed in revision and approval of the final draft of the manuscript.
Institutional review board statement: This case report was exempt by the Institutional Review Board Standards of the 2nd Surgical Department of National and Kapodistrian University of Athens.
Informed consent statement: The patient involved in this case report gave his written informed consent authorizing use and disclosure of his protected health information. A copy of the written consent remains available upon request for review.
Conflict-of-interest statement: All the authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is noncommercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Eirini Pantiora, MD, General Surgery trainee, 2nd Department of Surgery, Aretaieio Hospital, Medical School, University of Athens, 76 V. Sofias Str, 11528 Athens, Greece. eirinipantiora@gmail.com
Telephone: +30-21-07286176 Fax: +30-21-07286128
Received: November 15, 2015
Peer-review started: November 15, 2015
First decision: December 22, 2015
Revised: January 3, 2016
Accepted: January 29, 2016
Article in press: January 31, 2016
Published online: April 16, 2016
Abstract

Posterior reversible encephalopathy syndrome (PRES) is a clinico-ragiological syndrome presenting with neurological symptoms and characteristic radiologic findings. PRES occurs in the setting of various clinical conditions and requires prompt management of the causative factor for a full recovery. This is a case report of a Crohn’s disease patient who developed PRES syndrome during a complicated post-operative course. In the presence of multiple causative factors, sepsis was considered as the predominant one. After prompt management, the patient recovered with no permanent neurological damage.

Keywords: Crohn’s disease, Sepsis, Posterior reversible encephalopathy syndrome, Diagnosis

Core tip: We present the case of a Crohn’s disease patient who suffered posterior reversible encephalopathy syndrome in the setting of a troublesome post-operative course. The etiology has not been clarified, since various contributing factors existed, however sepsis represents the predominant reason. The patient was diagnosed early, since neurological consult was seeked immediately, and after prompt management, he fully recovered without neurological deficits. Our goal is to stress out the importance of clinical suspicion in such cases, as the post-operative course in a Crohn’s disease patient can often be perplexed and challenging.