Hypertensive encephalopathy may occur in pediatric patients at diastolic pressures of 100 to 110 mmHg. Reye syndrome follows a viral illness, such as influenza or varicella. Patients are afebrile and anicteric, and develop pernicious vomiting. Confusion and delirium may lead to increasing obtundation. Hemorrhagic shock and encephalopathy syndrome is a symptom complex of unknown cause that affects previously healthy infants. The common features include a mild prodromal, nonspecific illness of several days' duration followed by the onset of profuse, watery diarrhea that becomes bloody, and seizures. Patients present poorly perfused, with profound metabolic acidosis and evidence of disseminated intravascular coagulation. Laboratory evidence of hepatic, renal, pancreatic, and myocardial dysfunction is common.
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