In patients with severe PEM, the first stage of treatment consists of correcting fluid and electrolyte imbalances, treating infection with antibiotics that do not affect protein synthesis, and addressing related medical problems.
The absence of edema (fluid retention) distinguishes marasmus-like secondary PEM, a gradual wasting process that begins with weight loss and progresses to mild, moderate, or severe malnutrition (cachexia).
Kwashiorkor-like secondary PEM usually develops in children who have been severely burned, suffered trauma, or had sepsis (massive tissue-destroying infection) or another life-threatening illness.
PEM may also occur in children with illnesses that leave them unable to absorb vital nutrients or convert them to the energy essential for healthy tissue formation and organ function.
Mild, moderate, and severe classifications for PEM have not been precisely defined, but patients who lose 10-20 percent of their body weight without trying may have moderate PEM.
The type and intensity of symptoms depend on the patient's prior nutritional status, the nature of the underlying disease, and the speed at which the PEM is progressing.
Other symptoms of severe secondary PEM include baggy, wrinkled skin; constipation; dry, thin, or brittle hair; lethargy; pressure sores, and other skin lesions.
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The doctor should be consulted if a child has lost a significant amount of weight without trying, has persistent diarrhea, or has any other signs of PEM.
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