Western Journal of Emergency Medicine (May 2011)

Food Protein-Induced Enterocolitis Syndrome as a Cause for Infant Hypotension

  • Marna Rayl Greenberg,
  • Nicole Ceccacci,
  • Rezarta Lloyd,
  • Kevin R Weaver,
  • Ryan W. Coates

Journal volume & issue
Vol. 12, no. 4
pp. 512 – 514

Abstract

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Infants with food protein-induced enterocolitis syndrome (FPIES) may present to the emergency department (ED) with vomiting and hypotension. A previously healthy, 5-month-old male presented with vomiting and hypotension 2 to 3 hours after eating squash. The patient was resuscitated with intravenous fluids, antibiotics, and admitted for presumed sepsis. No source of infection was ever found and the patient was discharged. The patient returned 8 days later with the same symptoms after eating sweet potatoes; the diagnosis of FPIES was made during this admission. Two additional ED visits occurred requiring hydration after new food exposure. FPIES should be considered in infants presenting with gastrointestinal complaints and hypotension. A dietary history, including if a new food has been introduced in the last few hours, may help facilitate earlier recognition of the syndrome. [West J Emerg Med. 2011;12(4):512–514.]

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