We report on a 20-month-old girl who presented with vomiting and lethargy after being discharged fromthe ward following treatment for Kawasaki disease. The symptoms occurred after five days of aspirintherapy. The clinical features and laboratory tests proved the presence of Reye's syndrome and sherecovered after intensive treatment. In addition, we collected three similar reported cases. All the patientscame from East Asia and the mortality rate reached 50%. Since salicylate is an effective and imperativetreatment for Kawasaki disease, paediatricians and emergency physicians can consider using a low doseof aspirin (3-5 mg/kg) as maintenance therapy, discontinuing aspirin for a short period or replace it withdipyridamole during influenza or varicella epidemics, and having a high index of suspicion of Reye'ssyndrome in patients with Kawasaki disease.
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