Yesterday a three year-old presented with diarrhea for one week. On history and exam, he seemed mildly dehydrated and slightly pale, but he was smiling and playful. Nothing seemed out of the ordinary.

If I were in the DR Congo or Liberia, I would have given him some fluids orally and likely sent him home with follow-up in 24-48 hours. However, since we have access to a great laboratory, we ordered some tests.

When the results returned I was surprised. He was extremely anemic, had a very low platelet count and had kidney failure! He has Hemolytic Uremic Syndrome (HUS) and was on the verge of getting critically sick.

We jumped into action, quickly changed his fluid schedule, gave him some blood and admitted him for close observation. Hopefully, our efforts will save him.


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