Acute Febrile Illness with Loose Motions and Microcytic Hypochromic Anaemia in a Hyperactive Preschool Child: A Case Study with Nursing Care Implications

Background

Acute febrile illness accompanied by loose motions is a common presentation among preschool children in low- and middle-income settings, and may coexist with undiagnosed nutritional anaemia, complicating both diagnosis and recovery. Case Presentation: We report the case of a 3½-year-old male child who presented with a one-week history of fever, loose motions, poor oral feeding (bottle-fed), and hyperactive behaviour. On examination the child had marked pallor, tachypnoea, and a soft but tender abdomen. Investigations revealed a microcytic hypochromic anaemia (haemoglobin 9.1 g/dL), neutrophilic leukocyte differential, markedly elevated quantitative C-reactive protein (44.2 mg/L against a normal range of 0–6 mg/L), and mildly reactive Widal titres. Urinalysis showed trace proteinuria with a turbid appearance but was otherwise unremarkable. The child was managed with antipyretic/antispasmodic syrup, parenteral antimicrobial therapy, and supportive fluid management, with nursing care directed at hydration monitoring, nutritional support, and caregiver education.