When Food Makes a Child Sick
When Food Makes a Child Sick
A previously healthy 5-year-old girl presents to the emergency department with nonbloody, nonbilious emesis; nonbloody diarrhea; and abdominal pain. Her symptoms began approximately 24 hours ago, 12 hours after attending a school barbecue where she and her family ate broccoli, salad, french fries, and cheeseburgers. Sick contacts are her mother and sister, who also have vomiting and diarrhea, and several classmates with upper respiratory infections.
The patient's parents report that the frequency of the child's urine output has decreased in the previous 12 hours; however, she continues to void. Review of systems is positive for runny nose and cough for several days and negative for fever.
On physical examination, the girl appears well and is at the 50th percentile for height and weight. She is afebrile, with mild tachycardia and normal blood pressure. She has dry lips and mucous membranes. Cardiac examination reveals tachycardia without murmur, normal pulses, and a capillary refill time of 3 seconds. Her abdomen has high-pitched bowel sounds, and there is mild diffuse tenderness without masses or hepatosplenomegaly. The remainder of the physical examination is unremarkable.
The Case of the Sudden Illness
A previously healthy 5-year-old girl presents to the emergency department with nonbloody, nonbilious emesis; nonbloody diarrhea; and abdominal pain. Her symptoms began approximately 24 hours ago, 12 hours after attending a school barbecue where she and her family ate broccoli, salad, french fries, and cheeseburgers. Sick contacts are her mother and sister, who also have vomiting and diarrhea, and several classmates with upper respiratory infections.
The patient's parents report that the frequency of the child's urine output has decreased in the previous 12 hours; however, she continues to void. Review of systems is positive for runny nose and cough for several days and negative for fever.
On physical examination, the girl appears well and is at the 50th percentile for height and weight. She is afebrile, with mild tachycardia and normal blood pressure. She has dry lips and mucous membranes. Cardiac examination reveals tachycardia without murmur, normal pulses, and a capillary refill time of 3 seconds. Her abdomen has high-pitched bowel sounds, and there is mild diffuse tenderness without masses or hepatosplenomegaly. The remainder of the physical examination is unremarkable.