PDF(Pubmed)
Abstract：
Posterior reversible encephalopathy syndrome (PRES) is an acute neurological condition associated with different etiologies, including antibiotic therapy. To date, most data regarding antibiotic-related PRES are limited to case reports and small case series. Here, we report a novel case description and provide a systematic review of the clinico-radiological characteristics and prognosis of available cases of PRES associated with antibiotic therapy. We performed a systematic literature search in PubMed and Scopus from inception to 10 January 2024, following PRISMA guidelines and a predefined protocol. The database search yielded 12 subjects (including our case). We described the case of a 55-year-old female patient with PRES occurring one day after administration of metronidazole and showing elevated serum neurofilament light chain protein levels and favorable outcome. In our systematic review, antibiotic-associated PRES was more frequent in female patients (83.3%). Metronidazole and fluoroquinolones were the most reported antibiotics (33.3% each). Clinical and radiological features were comparable to those of PRES due to other causes. Regarding the prognosis, about one third of the cases were admitted to the intensive care unit, but almost all subjects (90.0%) had a complete or almost complete clinical and radiological recovery after prompt cessation of the causative drug. Antibiotic-associated PRES appears to share most of the characteristics of classic PRES. Given the overall good prognosis of the disease, it is important to promptly diagnose antibiotic-associated PRES and discontinue the causative drug.
摘要：
后部可逆性脑病综合征（PRES）是一种与不同病因相关的急性神经系统疾病，包括抗生素治疗.迄今为止,有关抗生素相关PRES的大多数数据仅限于病例报告和小病例系列.这里,我们报告了一个新的病例描述,并对现有的与抗生素治疗相关的PRES病例的临床放射学特征和预后进行了系统评价.从成立到2024年1月10日，我们遵循PRISMA指南和预定义的协议，在PubMed和Scopus进行了系统的文献检索。数据库搜索产生了12个受试者(包括我们的病例)。我们描述了一名55岁的女性PRES患者在服用甲硝唑后一天发生的情况，并显示出血清神经丝轻链蛋白水平升高和良好的预后。在我们的系统审查中，抗生素相关PRES在女性患者中更常见(83.3%).甲硝唑和氟喹诺酮类药物是报道最多的抗生素（各占33.3％）。由于其他原因，临床和放射学特征与PRES相当。关于预后，大约三分之一的病例被送往重症监护室，但几乎所有受试者（90.0％）在立即停止致病药物后，临床和放射学完全恢复或几乎完全恢复。与抗生素相关的PRES似乎具有经典PRES的大部分特征。鉴于该疾病的总体预后良好，及时诊断抗生素相关PRES并停用致病药物非常重要.
