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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 345:276-281 July 26, 2001 Number 4
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Case 23-2001— An 18-Month-Old Girl with Persistent Diarrhea and Malnutrition
Christopher P. Duggan, M.D., M.P.H., and Joseph Misdraji, M.D.

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Presentation of Case

An 18-month-old girl was admitted to the hospital because of diarrhea with intermittent constipation and vomiting.

The child had been born by cesarean section, performed because of a breech presentation, at 41 weeks' gestation; it was the mother's first pregnancy. The child's immunizations were up to date. She had had otitis media at 13 months of age. She was fed cow's milk–protein formula and grew normally, without diarrhea. At 15 months, her weight was 9.8 kg (30th percentile). Her only medication was a fluoride supplement.

Six weeks before admission, the child became irritable, and diarrhea developed, with foul-smelling, watery stools . . . [Full Text of this Article]

Differential Diagnosis

Iatrogenic Malnutrition

Congenital Disorders

Infection with Giardia lamblia

Infection with Cryptosporidium

Infection with Escherichia coli

Celiac Disease

Clinical Diagnosis

Dr. Christopher P. Duggan's Diagnosis

Pathological Discussion

Anatomical Diagnosis

References




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