Diarrhea with moderate to severe dehydration in a child

Case Profile

A male child, 5 years of age is brought to the ED by his parents with a h/o

•Vomiting and diarrhea since 2 days

History of presenting illness

His mother states that his illness started with vomiting, that was about 3-4 episodes which has resolved now.

He has had about 8-10 episodes of diarrhea for the past 2 days. It is watery, there is no blood or mucous.

He has had slight fever and is more tired than normal.

He has been refusing to eat.

His urine output is decreased and the urine colour is darker than usual.

Past history

He has had one similar episode of diarrhea in the past, when he was about 2 years old which was basically due to infection.

There is no other significant history in the past.

Developmental milestones were normal and his vaccination is up to date.

Physical examination

He is alert, but is very irritable
HR: 110/min
Respiratory rate: 22 breaths/min
BP 100/60 mmHg
Capillary refill: 3 seconds
CVS: Tachycardia
P/A: Soft, non-distended, non-tender, no peritoneal signs

Which of these correlates best with severity of dehydration based on the symptoms the patient presents with?


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