When paramedics arrived at the home of 11-month-old James, he was nearly in a coma. The first responders quickly inserted a breathing tube and brought him to the hospital. The toddler, who had recently started walking, had been completely happy and healthy only hours before. His sobbing mother had no idea what could be wrong with her precious only son. Our pediatric emergency room quickly jumped into action. Initial lab work was all normal, but James clearly was not well.