CASE :5

HIMANSHU GUPTA
GROUP : 627
PASSPORT DATA : 3YR OLD
MALE
Main complaints:
Bloody diarrhea
Pale appearance
HISTORY
 No fever, ill contacts, or recent exposure to children with diarrhea
 Attended a birthday party 7 days prior where the child consumed hot dogs and hamburgers
PHYSICAL EXAMINATION
 Pale conjunctiva
 Pale tongue
 Tachycardia with grade II/VI vibratory systolic ejection murmur at the left sternal border
 Clear lungs with good aeration
 Flat, soft, non-tender abdomen with liver edge palpable 3cm below the right costal margin
DIFFERENTIAL DIAGNOSIS
 Hemolytic uremic syndrome (HUS)
 Acute gastroenteritis
 Infectious colitis
 Inflammatory bowel disease (IBD)
 Foodborne illness (e.g., E. coli infection)
 Preliminary diagnosis:
 Hemolytic uremic syndrome (HUS)

 Tests done:
 CBC with peripheral smear
 Basic metabolic panel
 Coagulation studies
 Stool culture for infectious pathogens
 Shiga toxin testing
 Urinalysis
EVALUATION RESULT
 Elevated WBC count with left shift and anemia on CBC
 Schistocytes, helmet cells, and polychromasia on peripheral smear
 Elevated BUN, creatinine, LDH, and abnormal electrolytes on basic metabolic panel
 Normal coagulation studies
 Stool culture and Shiga toxin testing pending
DIAGNOSIS
 Hemolytic uremic syndrome
TREATMENT
 Supportive care including fluid and electrolyte management
 Monitoring for signs of renal failure
 Avoiding nephrotoxic medications
 Potential use of antibiotics if bacterial infection is confirmed
 THANK YOU