A 78 year old man traveller from India presents with a gastroenteritis like illness and weakness. He has hypotension and tachycardia requiring resuscitation.Blood results show:

NAGMA with life threatening hypokalaemia and moderate hyponatraemia as well as renal failure and a mild elevation in bilirubin.

Causes – dehydration and electrolyte loss secondary to diarrhoea

Causes of diarrhoea in traveller:

bacteria – e. coli, campylobacter, salmonella, shigella

virus – noro, rota

parasites – giardia, cryptosporidium, cyclospora, entamoeba

acute food poisoning

no cause

Treatment:

resuscitation

Central access – K replacement, monitor ECG/K

ICU/HDU admission