Snapshot A 7-year-old girl is brought to the emergency room for lethargy and altered mental status. She was born at full term and previously healthy. She recently complained of feeling muscle soreness, headaches, and some nausea. A few of her classmates at school had tested positive for influenza A, and she was instructed to stay home from school during this time. Her parents gave her an aspirin herself this morning for her symptoms. On physical exam, she is noted to be obtunded and had hepatomegaly. On laboratory evaluation, she had elevated liver enzymes. She is admitted to the intensive care unit for supportive care and careful monitoring of her intracranial pressure. Introduction Clinical definition login to view 1 more bullet Epidemiology login to view 9 more bullets Pathogenesis login to view 3 more bullets Prognosis login to view 1 more bullet Presentation Symptoms login to view 8 more bullets Physical exam login to view 7 more bullets Imaging Computed tomography (CT) of the brain login to view 4 more bullets Studies Diagnostic approach login to view 1 more bullet Serum labs login to view 4 more bullets Invasive studies login to view 6 more bullets Differential Inborn errors of metabolism, e.g., fatty acid oxidation defects, urea cycle defects, etc. login to view 4 more bullets Treatment Management approach login to view 3 more bullets Medical login to view 7 more bullets Complications Permanent brain damage Death