The clinical characteristics, treatment and possible causes of hemorrhagic shock and encephalopathy in infants are described and a 5-month-old patient is reported from the Section of Neurology, The Children’s Mercy Hospital, Kansas City, MO. The infant presented with fever and irritability. She developed respiratory distress, requiring endotracheal intubation, followed by cardiorespiratory arrest. Excessive bleeding from puncture sites was associated with a disseminated intravascular coagulopathy. Admission diagnosis was septic shock. Other complications of this encephalopathy are bloody diarrhea and hepatorenal failure. Treatment requires fluids and electrolytes, fresh frozen plasma, and vitamin K. Hyperthermia appeared important in causation. [1]

COMMENT. The syndrome was first described in Great Britain in 1983 as cited by the author [2]. The differential diagnosis includes septic shock, toxic-shock syndrome, Reye syndrome, and hemolytic-uremic syndrome. Early aggressive therapy was recommended.