A 2-month-old exclusively breastfed infant of a mother whose diet consists mainly of polished rice presents with tachycardia, tachypnea, cardiomegaly, and a weak hoarse cry. There is no fever and sepsis screen is negative. Intramuscular injection of a single vitamin produces dramatic clinical improvement within hours.
- A Vitamin C
- B Thiamine ✓
- C Pyridoxine
- D Riboflavin
Correct answer: B. Thiamine
Explanation
This is acute infantile beriberi, the wet cardiac form of thiamine deficiency. Breastfed infants of mothers consuming polished rice develop high-output cardiac failure with tachycardia, cardiomegaly, and the characteristic aphonic or hoarse cry due to recurrent laryngeal nerve palsy. Parenteral thiamine produces dramatic improvement within hours, which is both diagnostic and therapeutic. Vitamin C deficiency causes scurvy with skeletal and hemorrhagic features, not acute heart failure, and pyridoxine deficiency presents with seizures.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.