LAUSR

A 7-year-old girl was born after an uncomplicated pregnancy to non-consanguineous parents, and her past medical history was insignificant. Her psychomotor development was without any abnormalities. Six days before admission to our institute, she started vomiting repeatedly and had up to 8 diarrhea stools within 24 h. Over the next 2 days, her condition was also accompanied by a fever (38.5–39.2 °C). Initially, the girl was treated at home, but only symptomatically. However, since the vomiting persisted, she was admitted to the hospital. On physical examination, the patient was afebrile and showed signs of mild dehydration. Her blood pressure was 115/75 mmHg. Lung and heart auscultations were normal. Abdominal examination revealed a mildly distended abdomen, but no abdominal wall rigidity. Hepatosplenomegaly was not present. Initial biochemical investigations showed increased C-reactive protein 21.2 mg/l (reference range 0–5 mg/l), blood urea nitrogen 66.5 mmol/l (reference range 1.8–6.4 mmol/l), serum creatinine 369 μmol/l (reference range 30– 47 μmol/l), serum osmolality 345 mmol/kg (reference range 275–295 mmol /kg ) , and hype ru r i cemia 1865 μmol/l (reference range 140–340 μmol/l). Electrolytes, liver transaminases, total protein, albumin, alkaline phosphatase, glucose, and lactate dehydrogenase were all within normal ranges. A complete blood count showed a leukocyte count of 22.3 × 10/l with 85% neutrophils, a thrombocyte count of 345 × 10/l, and hemoglobin was 126 g/l. Urinalysis showed microscopic hematuria and a large number of uric acid crystals in the urinary sediment. Ultrasound examination of the kidneys showed a hyperechogenic renal cortex. Acute gastroenteritis was diagnosed based on a positive stool culture for Salmonella enteritidis.