Raphael S., 1

Raphael is the youngest child in his family and lives with his teenage mother and 7-year-old brother. The two children have different fathers, and Raphael’s father has been absent since before his birth. The family depends on their paternal grandfather, a casual laborer and the sole provider, and they live in a small one-room mud-walled house with a mud floor and iron sheet roof. With no stable income, meeting basic needs and accessing healthcare is often difficult. Raphael had been well until about nine days earlier when he developed vomiting, irritability, fatigue, and difficulty in breathing. His condition gradually worsened, with increasing weakness, poor feeding, and reduced activity, making him visibly unwell. He was first taken to a nearby health center, where he was treated for malaria, but his symptoms did not improve. As his condition continued to deteriorate, his mother took him to Siaya County Referral Hospital for further evaluation and urgent care.

Raphael was relieved in the emergency department with complaints of diarr,vomiting and general body malaise,general body weakness.Sample collected and taken to lab then later on taken to ward for further management.In the ward medication were done whereby ceffriaxone, fortified fingers,pcm,artesonate AL were prescribed and administered.He was managed and discharged and discharged on stable condition.

Raphael’s condition suggests a severe illness that has not responded to initial malaria treatment, raising concern for complications or an alternative diagnosis such as severe infection or respiratory involvement. His symptoms of persistent vomiting, fatigue, and difficulty in breathing indicated a critically unwell child requiring urgent reassessment, admission, and comprehensive investigations. He was started on supportive care, fluids, and appropriate treatment based on findings, with close monitoring. Prognosis is good. His recovery is expected to be gradual and closely monitored, with improvement seen as breathing stabilizes, feeding improves, and energy returns. Continued follow-up will be essential to ensure full recovery and prevent recurrence or complications.