Acute Febrile Illness with Loose Motions and Microcytic Hypochromic Anaemia in a Hyperactive Preschool Child: A Case Study with Nursing Care Implications

Background: Acute febrile illness accompanied by loose motions is a common presentation among preschool children in low- and middle-income settings, and may coexist with undiagnosed nutritional anaemia, complicating both diagnosis and recovery. Case Presentation: We report the case of a 3½-year-old male child who presented with a one-week history of fever, loose motions, poor oral feeding (bottle-fed), and hyperactive behaviour. On examination the child had marked pallor, tachypnoea, and a soft but tender abdomen. Investigations revealed a microcytic hypochromic anaemia (haemoglobin 9.1 g/dL), neutrophilic leukocyte differential, markedly elevated quantitative C-reactive protein (44.2 mg/L against a normal range of 0–6 mg/L), and mildly reactive Widal titres. Urinalysis showed trace proteinuria with a turbid appearance but was otherwise unremarkable. The child was managed with antipyretic/antispasmodic syrup, parenteral antimicrobial therapy, and supportive fluid management, with nursing care directed at hydration monitoring, nutritional support, and caregiver education. Conclusion: This case highlights the diagnostic value of combining haematological, serological, and inflammatory markers in the evaluation of febrile illness in young children, the cautious interpretation required for Widal serology, and the central role of community health nursing in early recognition, family counselling, and follow-up of anaemia in this age group.