Snapshot An 8-year-old boy is brought to the emergency room by his babysitter for sudden-onset vomiting. He had been feeling ill with headaches, fevers, and myalgias. Today, his parents gave him some anti-pyretics including acetaminophen and aspirin. When his babysitter arrived, he had progressive nausea with vomiting, diarrhea, and increased restlessness. On exam, he is lethargic with hepatomegaly. A head computed tomography shows cerebral edema and his laboratory evaluation reveals increased ammonia and liver enzyme levels. He is admitted to the intensive care unit for further management. (Reye syndrome) Introduction Overview login to view 2 more bullets Epidemiology Risk factors login to view 13 more bullets ETIOLOGY Pathogenesis login to view 3 more bullets Presentation Symptoms login to view 7 more bullets Physical exam login to view 7 more bullets Imaging Hepatic ultrasound login to view 6 more bullets Abdominal computed tomography (CT) login to view 6 more bullets Head CT login to view 4 more bullets Studies Serum labs login to view 15 more bullets Invasive studies login to view 3 more bullets Differential Septic shock login to view 3 more bullets Treatment Management approach login to view 2 more bullets Medical login to view 11 more bullets Surgical login to view 4 more bullets Complications Infections login to view 1 more bullet Seizures Hemorrhage Acute renal failure