Infectious gastroenteritis (acute) (pediatrics) Quiz: Ace Your Exams

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A 5-year-old boy is brought to the emergency department with a 12-hour history of sudden-onset vomiting, abdominal cramps, and watery diarrhea. A parent reports that symptoms began shortly after a birthday party where the child ate potato salad and cream-filled pastries. Temperature is 37.0 C (98.6 F), blood pressure is 115/70 mm Hg, heart rate is 90 beats per minute, respiratory rate is 16 breaths per minute, and oxygen saturation is 98% on room air. On examination, the child appears fatigued with tacky mucous membranes and capillary refill of < 2 seconds. Laboratory results are shown below. Which of the following is the best next step in management?

Laboratory ValueResultReference Range
White blood cell (WBC) count8,500/µL5,100-13,400/µL
Hemoglobin13.2 g/dL11.5-13.5 g/dL
Platelet count290,000/µL150,000-450,000/µL
Sodium138 mEq/L138-145 mEq/L
Potassium4.1 mEq/L4.1-5.8 mEq/L
Blood urea nitrogen (BUN)12 mg/dL5-17 mg/dL
Fecal lactoferrinNegativeNegative
Stool microscopyGram-positive cocci in clustersNegative for pathogens

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