Wasted

A one-week old boy presents with six episodes of non-bilious vomiting within the last 2 days and reduced urine output for the last 12 hours.

He is also lethargic and is feeding poorly. There is no history of fever or diarrhea.

His antenatal history is uncomplicated, with a birth weight of 3.2 kg. His family history is unremarkable. He was breastfed from birth.

Select Relevant Investigations
Serum Electrolytes

Performed

Na: 129 mEq/l
K: 6.9 mEq/l
Cl: 105 mEq/l
Septic screen

Performed

The septic screen is negative.
Renal profile

Performed

S. Creatinine: 0.7 mg/dl (normal: 0.3-1.2mg/dl)
Blood urea: 4 mmol/l (normal: 1.0-5.0 mmol/l)
Serum 17-hydroxyprogesterone

Performed

15 mg/ml (high)

Select Relevant Management
IV Fluids
IV Hydrocortisone
Stop breastfeeding
Antibiotics