Summary
Definition
History and exam
Key diagnostic factors
- history of famine or monotonous diet
- child <4 years of age and living in rural community
- low weight for height, low height for age, or a low mid upper arm circumference (MUAC)
- bilateral pitting edema
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 maize or cassava
- dietary protein deficiency
- HIV
- measles
- diarrhea
- weaning off the breast
- exposure to free radicals
- antioxidant deficiency
- aflatoxin poisoning
- incomplete immunization
- poor social or economic conditions
- cerebral palsy
Diagnostic investigations
Investigations to consider
- urine dipstick
- complete blood count (CBC)
- 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
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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