Abstract
A 2-month-old previously healthy term solely, breastfed female developed progressive difficulty feeding, vomiting, and poor weight gain. Emesis was recurrent and projectile, with new-onset watery diarrhea that was occasionally blood-tinged. By day 5 of symptoms, she appeared severely dehydrated and was evaluated in the emergency department. Examination was significant for a thin, cachectic infant with sunken fontanelle, lethargy, and poor perfusion, with heart rate in the 190s and hypotension, lending a diagnosis of uncompensated hypovolemic shock.
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