MEDizzy - A 6-month-old infant with protein-calorie malnutrition

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Pediatric Nutrition Part I

A 6-month-old infant with protein-calorie malnutrition receiving boiled milk from birth presented with anorexia, apathy, vomiting, restlessness, progressive pallor, dyspnea, and cyanosis. The baby is noticed to cry without sound. Of the following, the MOST likely cause of his condition is deficiency of

ExplanationInfantile beriberi occurs between 1 and 4 months of age in breastfed infants whose mothers have a thiamine deficiency (alcoholism), in infants with proteincalorie malnutrition, in infants receiving unsupplemented hyperalimentation fluid, and in infants receiving boiled milk. Acute wet beriberi with cardiac symptoms and signs predominates in infantile beriberi. Anorexia, apathy, vomiting, restlessness, and pallor progress to dyspnea, cyanosis, and death from heart failure. Infants with beriberi have a characteristic aphonic cry; they appear to be crying, but no sound is uttered. Other signs include peripheral neuropathy and paresthesias.