Akakkarappan is a disease mentioned in the Malayalam text- Vaidyatarakam (Regional pediatric ayurveda textbook from Kerala in Malayalam language).The disease is specific for its gastrointestinal symptoms along with skin manifestations. The prevalence is higher in the pediatric age group. Here, an attempt is made to evaluate the clinical efficacy of Ayurvedic formulation in managing Akakkarappan. A 9-month-old male infant was presented with complaints of greenish frothy stool along with fever and skin lesions. The child was treated with the concepts of Agni (digestive fire), Dushi visha (accumulated toxin), Karappan (skin lesions in children) and Atisara (diarrhoea) as per the clinical experience and available reference of Akakkarappan. The child was relieved of all gastrointestinal symptoms and skin lesions with Ayurvedic treatment within seven days. Also, the digestive fire (Agni) was restored within two weeks. Ayurvedic formulations from the contexts of Dushi visha (accumulated toxin), Karappan (skin lesions in children) and Atisara (diarrhoea) were able to provide symptomatic relief and restore the normalcy of Agni in the infant with Akakkarappan.