References:
- Global Infectious Diseases and Epidemiology Online Network: Infectious Diseases of the Philippines, 2013 eBook Edition, ISBN 978-1-61755-582-4, by Stephen Berger. Accessed here.
| Agent | Unknown |
| Reservoir | Unknown |
| Vector | None |
| Vehicle | Unknown |
| Incubation Period | Unknown |
| Diagnostic Tests | Clinical diagnosis |
| Typical Adult Therapy | Electrolyte and glucose management, (?) enemas, (?) dialysis |
| Typical Pediatric Therapy | As for adult |
| Clinical Hints | Vomiting, lethargy, coma, seizures, hepatomegaly, hypoglycemia and elevated blood ammonia concentration; usually anicteric; follows viral infection; aspirin ingestion is often implicated. |
| Synonyms | Reye syndrome |
Signs and symptoms of Reye’s syndrome include protracted vomiting and encephalopathy, in the absence of fever or jaundice.
- Hepatomegaly is present in 50% of cases.
- Twelve hours to 3 weeks following an antecedent viral illness, the patient develops vomiting and lethargy, followed by restlessness, irritability, combativeness, disorientation, delirium, tachycardia, hyperventilation, dilated pupils with sluggish response, hyperreflexia, positive Babinski sign, and appropriate response to noxious stimuli.
Diarrhea and hyperventilation are often the first signs in children below age 2 years.
- Later, obtundation, coma and decorticate rigidity are associated with inappropriate response to noxious stimuli.
- Coma deepens, and the patient is found to have fixed and dilated pupils, loss of oculovestibular reflexes and dysconjugate gaze with caloric stimulation.
- Seizures ensue, with flaccid paralysis, absent deep tendon reflexes, lack of pupillary response and respiratory arrest.
Similar disease (Reye-like syndrome) is caused by inborn errors of metabolism, hypoglycemia, hypoketonemia, elevated ammonia, and organic aciduria.
- A case of encephalopathy and hepatic failure similar to Reye’s syndrome was related to Bacillus cereus food poisoning.