Approach to diarrhea (pediatrics) Quiz: Ace Your Exams
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A 16-year-old boy presents to the emergency department with diarrhea and crampy abdominal pain for eight days. He has had more than five episodes of diarrhea per day and bright red blood was noted to be mixed in the stool today. He had mild nausea at the onset of the illness but has not vomited. The patient reports that he ate grilled chicken last week at a restaurant that recently was in the news for having a Campylobacter outbreak. He does not have any chronic medical conditions. He has not taken antibiotics recently and has not travelled. Temperature is 38.2°C (100.8°F), pulse is 120/min, respiratory rate is 20/min, and blood pressure is 120/72 mmHg. On examination, the patient is awake and alert. Mucus membranes are mildly dry. Cardiopulmonary examination is within normal limits other than mild tachycardia. There is mild diffuse tenderness to palpation of the abdomen but no guarding or rebound tenderness. Laboratory studies are shown below. A stool sample is collected. Which of the following is the best next step in management?
| Laboratory values | |
| Hemoglobin | 13.5 g/dL |
| Hematocrit | 39.3% |
| Leukocyte count | 7,800/mm3 |
| Platelet count | 242,000/mm3 |
| Sodium | 139 mEq/L |
| Bicarbonate | 24 mEq/L |
| Blood urea nitrogen | 18 mg/dL |
| Creatinine | 1.0 mg/dL |
| Glucose | 75 mg/dL |
| Calcium | 9.1 mg/dL |
| Potassium | 3.7 mEq/L |
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