A Case Report of Severe Dehydration and Complications in a 10 Month Old Baby Girl Presenting with Acute Diarrhoea in a Resource-Limited Hospital Setting

Abstract

Introduction: Diarrhoea continues to pose a significant threat to child health, often resulting in severe complications such as hypovolemic shock, electrolyte imbalances, and metabolic acidosis, which can lead to morbidity and mortality. This case study aims to illustrate the management of diarrhoea in a resource-constrained hospital setting.

A 10 Month old Baby Girl presented with symptoms including frequent watery stools (10 times/day), vomiting (3 times/day), and fever. The child exhibited signs of dehydration, weakness, refusal to drink, rapid and labored breathing, and loss of consciousness. Physical examination revealed a high heart rate (165 beats per minute), impalpable peripheral pulse, elevated respiratory rate (44 breaths per minute), normal oxygen saturation (98%), and slight hypothermia (36.7°C). Additionally, the child displayed clinical signs of dehydration such as sunken eyes, reduced tear production, diminished bowel sounds, delayed skin turgor, and prolonged capillary refill time.

Laboratory investigations showed leukocytosis (23,600/μl), hyponatremia (127 mmol/l), and hypokalemia (2.66 mmol/l). Treatment commenced with rapid fluid resuscitation using Ringer lactate at 20 ml/kg BW over 20 minutes, followed by 30 ml/kg BW over the next 30 minutes, and finally 70 ml/kg BW over 2 hours and 30 minutes. Subsequently, the patient received D5% 500 cc with sodium bicarbonate and KCL 7.4% within 24 hours. Oxygen therapy, antibiotics, probiotics, and zinc supplementation were also administered.