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Chronic, progressive form: anorexia, failure to thrive, gastrointestinal symptoms, psychomotor retardation Reye‐like illness in infancy or early childhood; recurrent acidosis, hypoglycemia, coma; continual presentation with developmental delay has been described Variable presentation, including recurrent acidosis, hepatomegaly, Reye‐like episodes, speech delay, hypotonia Neonatal, infantile, or childhood presentation with vomiting, lethargy, coma, hyperammonemia, and hypoketotic hypoglycemia; Reye‐like illness past the neonatal interval Variable presentation with dysmorphism, failure to thrive, psychomotor retardation, ataxia, recurrent fever with rash, diarrhea and vomiting; milder variant with periodic fever and hyperimmunoglobulinemia D Infantile presentation with ketoacidosis throughout acute infections; hyperglycemia and hyperammonemia could occur; asymptomatic between attacks Hepatomegaly, hyperammonemia, elevated transaminases, fatty infiltration on biopsy; pancreatitis has been described – Isolated 3‐methylcrotonyl‐CoA carboxylase deficiency 3‐Methylglutaconyl‐CoA hydratase deficiency three‐Hydroxy‐three‐methylglutaryl‐CoA lyase deficiency Mevalonate kinase deficiency (mevalonic aciduria) Mitochondrial acetoacetyl‐CoA thiolase deficiency (β‐ketothiolase deficiency) 3‐Hydroxyisobutyric aciduria Malonic aciduria Infantile presentation with dysmorphism, brain malformations, ketosis, acidosis, failure to thrive Presentation in infancy or early childhood with acidosis, hypoglycemia, developmental delay and cardiomyopathy Biochemical and histological features resembling Reye syndrome Liver dysfunction and Reye‐like options have been described Biochemical and histological options resembling Reye syndrome Hepatosplenomegaly and cholestatic liver illness have been described Fatty infiltration of the liver has been described Not described Not described Chapter 19: Metabolic Liver Disease within the Infant and Older Child    319 requires a collection of enzymes with carbon chain length specificity antibiotic spray 500 mg ciplox otc. 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