August 10, 2026

A 7-year-old male recently arrived from the Democratic Republic of Congo presents for a “wellness check” from a resettlement agency. No U.S. medical records. His mother reports fatigue, poor appetite, and one episode of bloody stool. Vaccinations are unverified. On exam he is pale and has a mildly distended abdomen and scattered excoriated papules on trunk and extremities. What is on your differential? What makes the differential and workup for this patient different than the average pediatric patient?