A 3-year-old male is brought to the ED by his mother when she noted bloody diarrhea earlier in the day. There is no fever, ill contacts, or recent exposures to children with diarrhea. He is noted to be pale. His family had attended a birthday party 7 days prior where the child had consumed red processed meat. Physical Exam: VS T 37.7, P 150, R 28, BP 100/45, oxygen saturation 100% in RA. Weight 17 kg (75%ile). He is alert but fussy, pale, and non-toxic appearing. His conjunctiva are pale.
His TMs are normal. He has no nasal flaring or palatal petechiae. His oral mucosa is moist and his tongue is pale. His neck is supple without adenopathy. His heart has a regular rhythm with tachycardia and a grade III/VI vibratory systolic ejection murmur at the left sternal border without radiation. No heaves, lifts, thrills, rubs, or gallops are present. His lungs are clear with good…
