Elusive Belly Pain and Guillain-Barré Syndrome
Elusive Belly Pain and Guillain-Barré Syndrome
S.L. is a previously healthy 3-year-old Hispanic girl who is brought to the emergency department (ED) by her mother because she refuses to eat, is complaining about lower abdominal pain, and has generalized "tiredness." S.L.'s mother states that the child was "fine" up until yesterday evening, when the child did not eat much of her dinner. Her mother thought that she was just tired, so she put her to bed earlier than usual. S.L. awoke at her usual time in the morning, drank "a little bit of juice" and ate "bites of French toast," and then spent most of the morning on the couch with her grandmother. As the day progressed, she became less active and "looked drowsy." S.L. did not have any interest in eating but would sip fluids intermittently. Her last bowel movement was yesterday; however, it was not witnessed. Occasionally, S.L. would complain of "belly pain" when she urinated, and her mother described the pain as "waxing and waning" but unrelieved. S.L.'s mother denies that the child has had fever, vomiting, diarrhea, hematuria, foul-smelling urine, or polydipsia. S.L. had no history of abdominal trauma, no contacts with sick people, and she had not recently traveled.
S.L. is a previously healthy 3-year-old Hispanic girl who is brought to the emergency department (ED) by her mother because she refuses to eat, is complaining about lower abdominal pain, and has generalized "tiredness." S.L.'s mother states that the child was "fine" up until yesterday evening, when the child did not eat much of her dinner. Her mother thought that she was just tired, so she put her to bed earlier than usual. S.L. awoke at her usual time in the morning, drank "a little bit of juice" and ate "bites of French toast," and then spent most of the morning on the couch with her grandmother. As the day progressed, she became less active and "looked drowsy." S.L. did not have any interest in eating but would sip fluids intermittently. Her last bowel movement was yesterday; however, it was not witnessed. Occasionally, S.L. would complain of "belly pain" when she urinated, and her mother described the pain as "waxing and waning" but unrelieved. S.L.'s mother denies that the child has had fever, vomiting, diarrhea, hematuria, foul-smelling urine, or polydipsia. S.L. had no history of abdominal trauma, no contacts with sick people, and she had not recently traveled.
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