Last reviewed: November 2017
Last updated: October  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • low weight for height, low height for age, or a low mid upper arm circumference (MUAC)
  • bilateral pitting oedema

Other diagnostic factors

  • hair discoloration
  • dermatosis/ulceration
  • apathy and reluctance to feed
  • hypothermia
  • oral candida
  • xerophthalmia
  • pallor
  • poor hydration
  • fever
  • irritability

Risk factors

  • endemic food insecurity or famine
  • rural communities
  • <4 years of age
  • monotonous diet based on corn or cassava
  • dietary protein deficiency
  • HIV
  • measles
  • diarrhoea
  • weaning off the breast
  • exposure to free radicals
  • antioxidant deficiency
  • aflatoxin poisoning
  • incomplete immunisation
  • poor social or economic conditions
  • cerebral palsy

Diagnostic investigations

Investigations to consider

  • urine dipstick
  • full blood count (FBC)
  • serum electrolytes
  • serum protein
  • serum albumin
  • blood glucose
  • chest x-ray (CXR)
  • urine culture
  • blood culture
  • stool culture
  • tuberculosis (TB) skin testing
  • HIV serology/polymerase chain reaction (PCR)
  • malaria screen
  • echocardiography
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Helene B. Roberson Professor of Pediatrics

Washington University School of Medicine

St Louis

MO

Disclosures

MJM is an author of a number of references cited in this monograph.

Medical Director

Lao Friends Hospital for Children

Luang Prabang

Laos

Associate Professor of Pediatrics

Washington University School of Medicine

St Louis

MO

Disclosures

IT is the co-author of a reference cited in this monograph.

Dr Mark J. Manary and Dr Indi Trehan would like to gratefully acknowledge Dr James E.G. Bunn, the previous contributor to this monograph. JEGB declares that he has no competing interests.

Peer reviewers VIEW ALL

Consultant Paediatrician

University Teaching Hospital

Department of Paediatrics and Child Health

Lusaka

Zambia

Disclosures

BA declares that she has no competing interests.

Adjunct Professor

Public Health Nutrition

James P. Grant School of Public Health

BRAC University

Dhaka

Bangladesh

Disclosures

TA declares that he has no competing interests.

Professor of Pediatrics and Health Policy and Management

University of Arkansas for Medical Sciences

Little Rock

AR

Disclosures

GJF declares that he has no competing interests.

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