Here’s a clear, anonymized clinical summary of the information provided:
🧾 Clinical Summary (No Identifiers)
🧒 Presentation
Poor oral intake and weight loss
Feeding refusal, especially during illness
Intermittent non-bilious vomiting
Episodic abdominal pain
Background of recurrent infections and persistent rhinorrhoea
Family concerns about ongoing illness
🩸 Key Medical Issues
Iron deficiency anaemia
Neutropenia (recurrent; counts as low as ~0.2–0.9)
Thrombocytosis
History of recent viral infections (adenovirus, coronavirus, prior COVID)
⚖️ Growth & Nutrition
Weight fluctuating during admission (approx. 10.2 → 10.7 → 10.4 kg)
Ongoing poor oral intake
Currently receiving nasogastric (NG) feeding with target ~1000 ml/day
Dietitian and feeding team involved
🔍 Investigations
Bloods:
Mild microcytic anaemia (Hb ~106–109)
Persistent neutropenia
CRP low
Liver function and immunology largely normal
Stool tests:
Calprotectin initially raised → normalized
Cultures and PCR negative
C. diff negative
Imaging:
Abdominal ultrasound: normal
Barium swallow: normal
🧠 Other Assessments
Feeding team (SALT) reviewed multiple times
No structural abnormalities identified
No clear gastrointestinal pathology identified so far
🏥 Current Management
NG feeding in place
Proton pump inhibitor (omeprazole)
Iron supplementation
Regular weight monitoring
Ongoing dietitian and multidisciplinary input
⚠️ Ongoing Concerns / Plans
Recurrent neutropenia → plan for autoimmune neutropenia screen
Consideration of endoscopy (pending parental decision)
Possible need for long-term NG feeding at home
Decision pending on discharge with NG tube
If still neutropenic, may require specific access precautions
🧩 Overall Impression
Complex case of feeding difficulty and faltering growth
No clear structural or infectious gastrointestinal cause identified
Significant contributing factors likely include:
Recurrent illness
Feeding aversion
Nutritional deficiency
Hematological abnormalities (especially neutropenia) require further evaluation
If you want, I can turn this into:
a discharge summary
a problem list with differential diagnoses
or a “what’s most likely going on” clinical interpretation 👍
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