A 3 year old female is brought into ED with a 3 day history of fever, coryzal symptoms and vomiting. Over the last 24 hours the parents report she has not been able to tolerate anything orally. The child has no significant past medical history, and her immunisations are up to date.
Vitals : HR 130 Temp 38.9 RR 30 Sats 98% RA BP 100/70
CPR <2sec Wet mucous membranes
BSL 4.5mmol/l Ketones 4.9 mmol/l
A VBG is done which shows a mild compensated metabolic acidosis with normal electrolytes and lactate
- What are the causes of ketosis in children and what is the most likely cause in this child?
- How would you manage this child?