A tale of two kiddies

Within a few hours of starting work, two children came to the pediatric ward with the same complaint. They were both swollen from their feet to their head. Neither could open their eyes more than a sliver and their feet were so edematous it was hard to tell what they were.

Two years ago I would have had trouble differentiating the cases but, after working a significant time in the developing world, I was able to diagnose them from 20 feet away.

One had skin changes, relatively subtle changes in his hair and was weak. His diagnosis was Kwashiorkor (a severe form of malnutrition) and he was extremely sick. Without urgent treatment, he would die.

The other had no stigmata of malnutrition and I diagnosed him with a kidney problem called nephrotic syndrome. He was not terribly ill and I simply started him on steroids.

It was interesting to see two kids with the same parental complaint but two drastically different treatment plans.

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