Which Weight? An Obesity Label Justified Against the Criterion It Does Not Meet, and Per-Kilogram Annotations No Single Body Weight Reproduces, in a 7-Year-Old Girl with Dengue with Warning Signs and Upper Gastrointestinal Bleeding: A Case Report

Vollständiger Abstract

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Background: In children with excess weight, fluid rates, drug doses, urine output, and energy prescriptions depend on a body weight that is often not identified in the clinical record. Objective: To audit the nutritional classification and implied dosing weights documented for a child with dengue with warning signs and upper gastrointestinal bleeding. Methods: This CARE-guided case report reviewed the de-identified record of a 7-year-old Indonesian girl and recomputed anthropometric indices, weight-indexed orders, and a recorded metabolic-rate calculation. Results: At 30 kg and 125 cm, body mass index was 19.20 kg/m² (92.4th centile), below the recorded obesity criterion, whereas weight for height was 123.4% of the median and supported obesity. No single body weight reproduced all printed per-kilogram annotations, and height had been entered in metres in a metabolic-rate equation requiring centimetres. The child recovered without shock, fluid bolus, transfusion, or respiratory support and was discharged on illness day 8. Conclusion: The nutritional label remained supportable by one criterion but not by the criterion cited in the record. Naming the dosing weight and its basis in every weight-indexed order would make paediatric dengue records more auditable.