Zara B., 8

Zara Bukar is an eight-year-old girl with a quiet strength and a gentle smile. She is the middle child in a large family of seven children she has three younger sisters and three older siblings. She lives with her parents in a small, overcrowded mud house in a poor settlement on the outskirts of Birniwa town. Her father is a laborer who works on other people's farms for meager wages, earning barely enough to buy food for his family. Her mother is a housewife who cares for the children and does what she can to stretch the little money they have. They have no savings, no health insurance, and no family support. Zara is a responsible girl who helps her mother care for her younger sisters. Her parents dream of her growing up healthy, going to school, and having a better future than their own. Zara Bukar, an eight-year-old girl, with a one-week history of high fever, chills, severe right-sided flank pain, painful urination, frequency of urination, nausea, vomiting, and profound lethargy. Her mother reported that Zara had become increasingly weak and confused over the past 48 hours. She was difficult to arouse and had stopped eating and drinking. On examination, Zara was found to be critically ill febrile with a temperature of 39.6°C, tachycardic, hypotensive, and severely lethargic. She had right costovertebral angle tenderness, pallor, and signs of dehydration. Laboratory tests confirmed acute kidney injury (creatinine 2.4 mg/dL, BUN 45 mg/dL), pyelonephritis (urinalysis positive for leukocytes, nitrites, and bacteria), and severe Plasmodium falciparum malaria (parasitemia 4.2%). She was diagnosed with acute kidney disease (acute kidney injury) complicated by pyelonephritis and severe malaria.

Zara Bukar, an eight-year-old girl, presented with acute kidney injury (creatinine 2.4 mg/dL, BUN 45 mg/dL), pyelonephritis (positive urinalysis), and severe malaria (parasitemia 4.2%). She was severely lethargic, febrile (39.6°C), and hemodynamically unstable. She needed immediate treatment with intravenous antibiotics (ceftriaxone and metronidazole), intravenous antimalarials (artesunate), intravenous fluids, and close monitoring of renal function, urine output, and vital signs. Prognosis is good with prompt and aggressive treatment. Full recovery of renal function is expected with appropriate management.