Acute-onset tachypnea, tachycardia, and reduced activity in a 16-month-old girl

摘要

A 16-month-old girl presents to the emergency department with rapid breathing, fatigue, malaise, and drastically diminished activity level of i-day duration. She has had persistent nasal congestion for the past 2 weeks without fever, cough, or wheezing. She most recently has begun to experience repeated episodes of emesis. The emesis is nonbilious and without blood. Despite persistent emesis, she has managed to keep up with her fluid losses and has normal urine output. She has a history of bilateral hydronephrosis with no other significant medical or family history.