A 9-Day-Old With Weight Loss and Diarrhea

A 9-day-old infant girl presented with diarrhea and weight loss of 19% since birth. She was born via spontaneous vaginal delivery at 39 weeks' gestation to a mother positive for group B who received adequate intrapartum prophylaxis. The infant was formula-fed every 2 to 3 hours with no reported...

Full description

Saved in:
Bibliographic Details
Published in:Pediatrics (Evanston) 2017-05, Vol.139 (5), p.E20162953
Main Authors: Rajbhandari, Prabi, Mandelia, Chetan, Janjua, Halima S, Selvakumar, Praveen Kumar Conjeevaram, Krishna, Sangeeta
Format: Article
Language:English
Subjects:
Acidosis
Babies
Blood cells
Body weight loss
Carbohydrate Metabolism, Inborn Errors - diagnosis
Carbohydrate Metabolism, Inborn Errors - therapy
Cardiomyopathy
Diagnosis, Differential
Diarrhea
Diarrhea - etiology
Feeding
Female
Fluid management
Genetics
Gestation
Girls
Gram-positive bacteria
Health aspects
Humans
Hyperkalemia
Hypernatremia
Infant, Newborn
Infants
Injury analysis
Kidneys
Malabsorption Syndromes - diagnosis
Malabsorption Syndromes - therapy
Metabolic acidosis
Pediatrics
Prophylaxis
Risk factors
Sodium-Glucose Transporter 1 - genetics
Swallowing
Vagina
Weight control
Weight Loss
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A 9-day-old infant girl presented with diarrhea and weight loss of 19% since birth. She was born via spontaneous vaginal delivery at 39 weeks' gestation to a mother positive for group B who received adequate intrapartum prophylaxis. The infant was formula-fed every 2 to 3 hours with no reported issues with feeding or swallowing. The infant had nonmucoid watery stools ∼5 to 15 times per day. Her family history was significant for hypertrophic cardiomyopathy in several of her family members. Her initial vital signs and physical examination were normal. Laboratory data on hospital admission showed a normal complete blood cell count, but her chemistry analysis revealed significant hypernatremia, hyperkalemia, metabolic acidosis, and acute kidney injury. Her hypernatremia was resistant to fluid management. In this article, we discuss the infant's hospital course, our clinical thought process, and how we arrived at our final diagnosis.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2016-2953