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Septicemic plague that mimics Reye's syndrome.

Yersinia pestis is an uncommon cause of infection in childhood. The report to follow illustrates a case where the clinical picture was consistent with Reye's syndrome and the ultimate diagnosis was primary septicemia plague ( Ypestis ). Report of a Case .—A 16-year-old boy went rabbit hunting near his home and skinned several carcasses four days prior to admission. On the day of admission, he reported malaise and headache. During that day, the patient became delirious and disoriented. He was also noted to be febrile and hallucinating. His WBC count was 26,800/cu mm, with 79% neutrophils, 7% band forms, and 19% lymphocytes. The blood ammonia level was 273 μg/dL (normal range, The patient was transported to Colorado General Hospital, Denver, with a tentative diagnosis of Reye's syndrome. On admission, physical examination showed an agitated, restless, disoriented teenager. His temperature was 39.7 °C, with normal vital signs. Results of eye