• He was brought to the clinic by ones of his brothers.
• About 2 weeks ago, he had an episode of diarrhea and transient abdominal pain.
• He recovered from that earlier episode, but continued to have intermittent fevers.
• Two days ago he began to complain of severe abdominal pain.
• Otieno's father has four wives and 28 children.
• They live in a rural setting and their drinking water comes from a near by stream.

• Several of Otieno's siblings have a had a chronic febrile illness and one died several weeks ago.
• Otieno's Vital signs:
• Temp = 103.2°F,
• Pulse = 110/min, and thready
• BP = 106/60 mmHg
• Respirations = 22/min and regular

Physical findings.