Sam, a 10-Month-Old Boy with Hypoglycemia

Abstract

CASE PRESENTATION Sam, a 10-month-old boy who was born full term, presents to the emergency department (ED) with vomiting, diarrhea, and lethargy. During the ED evaluation, he is found to have a point-of-care (POC) glucose level of 37 mg/dL (2.05 mmol/L). He is unable to tolerate oral intake; therefore, he is given an intravenous (IV) bolus of dextrose 10% in water totaling 5 mL/kg. A repeat POC blood glucose level is obtained, which is 82 mg/dL (4.55 mmol/L). Sam is then placed on maintenance IV fluids of 5% dextrose in normal saline. Afterward, he is still sleepy and shows no interest in drinking but is becoming more responsive. Because he is young and is still showing no interest in drinking fluids, the ED physician calls you to evaluate him for admission.