A child is found to have mid-upper arm circumference (MUAC) of 10.8 cm, bilateral pitting oedema up to mid-shin, and presence of flaky-paint skin changes. The MOST accurate diagnosis and WHO severity classification is:
- A Severe acute malnutrition (SAM) — kwashiorkor type
- B Moderate acute malnutrition with oedema
- C Severe acute malnutrition (SAM) — marasmic-kwashiorkor ✓
- D Severe acute malnutrition — marasmus type
Explanation
WHO classifies SAM as: marasmus (severe wasting — MUAC <11.5 cm, WHZ <-3, no oedema), kwashiorkor (bilateral pitting oedema without or with modest wasting), and marasmic-kwashiorkor (both severe wasting AND bilateral oedema present simultaneously). This child has MUAC 10.8 cm (indicating severe wasting/marasmus) plus bilateral pitting oedema (indicating kwashiorkor), making it marasmic-kwashiorkor — the most severe form with the highest mortality. Flaky-paint dermatosis is characteristic of kwashiorkor/marasmic-kwashiorkor due to protein deficiency and pellagroid skin changes.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.