{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:49:30Z","timestamp":1782488970631,"version":"3.54.5"},"reference-count":5,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,22]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>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 \u20183 P\u2019s of PRES\u2019 framework\u2014Pressure, Pattern and Pictures\u2014for earlier recognition and management.<\/jats:p>","DOI":"10.1136\/bcr-2025-269939","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:50:22Z","timestamp":1767678622000},"page":"e269939","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Posterior reversible encephalopathy syndrome in a child with leptospira-associated glomerulonephritis: the 3 P\u2019S framework"],"prefix":"10.1136","volume":"19","author":[{"given":"Bing Chan","family":"Shu","sequence":"first","affiliation":[{"name":"Emergency Department, Sarawak General Hospital, Kuching, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2240-5518","authenticated-orcid":false,"given":"Caisha","family":"Moses","sequence":"additional","affiliation":[{"name":"Emergency Department, Sarawak General Hospital, Kuching, Malaysia"},{"name":"Emergency Department, Hospital University Sains Malaysia, Kota Bharu, Kelantan, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"2026062608100582000_19.1.e269939.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00111-8"},{"key":"2026062608100582000_19.1.e269939.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-016-8377-8"},{"key":"2026062608100582000_19.1.e269939.3","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2020.00585","article-title":"Childhood Posterior Reversible Encephalopathy Syndrome: Clinicoradiological Characteristics, Managements, and Outcome","volume":"8","author":"Chen","year":"2020","journal-title":"Front Pediatr"},{"key":"2026062608100582000_19.1.e269939.4","doi-asserted-by":"crossref","DOI":"10.1177\/2333794X20947924","article-title":"Challenges of Diagnosing Pediatric Posterior Reversible Encephalopathy Syndrome in Resource Poor Settings: A Narrative Review","volume":"7","author":"Ndu","year":"2020","journal-title":"Glob Pediatr Health"},{"key":"2026062608100582000_19.1.e269939.5","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.3174\/ajnr.A0929","article-title":"Posterior reversible encephalopathy syndrome, part 2: controversies surrounding pathophysiology of vasogenic edema","volume":"29","author":"Bartynski","year":"2008","journal-title":"AJNR Am J Neuroradiol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269939","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:10:44Z","timestamp":1782486644000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269939"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":5,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,5]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bcr-2025-269939"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269939","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}