Reye Syndrome

Cause Reye syndrome is not caused directly by an infection but is the result of an infection-related injury to liver and brain cells. Nearly all cases are associated with a viral infection such as the chicken pox, flu, or an upper respiratory infection. The use of salicylates like aspirin to treat these infections appears to be linked to Reye syndrome.

Symptoms Symptoms are usually preceded by a viral illness and include nausea, vomiting, lethargy, confusion, and rapid breathing. In later stages, the child becomes comatose with dilated pupils. The liver may be enlarged, but there is no jaundice or fever.

How It Spreads The viruses that can lead to Reye syndrome are contagious, but the disorder itself is not.

Incubation Period Symptoms usually develop 1 to 14 days after viral infection, but they may begin as late as two months after the infection.

How Long Symptoms Last In mild cases, symptoms may disappear rapidly, but in the rarer severe cases, they can progress to death within hours. Progression of symptoms can also stop at any stage, with complete recovery in 5 to 10 days.

When to Call Your Child's Doctor Call your child's doctor immediately if, following a viral illness, your child shows symptoms of nausea, vomiting, or behavioral changes.

How the Diagnosis Is Made There is no single diagnostic test, but your child's doctor will check liver function with blood tests, and he or she may order a CT scan or MRI if he or she suspects brain swelling. A spinal tap (lumbar puncture) may be performed to rule out other conditions affecting brain function.

Treatment A child who is severely ill will be closely monitored in the intensive care unit, where the focus is on maintaining proper fluid balance and support of heart and lung function until problems in the brain and liver subside.

Prevention Aspirin and other salicylate-containing drugs should not be used in the treatment of chicken pox, flu, and other viral illnesses. Aspirin is not recommended to treat any routine illness in children younger than 12.

Contagious Periods The disease itself is not contagious. It occurs more frequently when viral diseases are more prevalent such as in the winter or following an outbreak of chicken pox or influenza B.

Complications Reye syndrome is still not well understood, but its incidence has fallen dramatically since the condition was first recognized in the 1960s, perhaps due to the decreased use of aspirin to treat symptoms of viral illnesses in children. Earlier diagnosis and treatment have reduced the mortality rate to about 20 to 30 percent. Children who progress to the late stages of the syndrome often have neurological problems.

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