A 5-MONTH-OLD male infant had presented with chronic nonbilious emesis at age 3 weeks and was briefly hospitalized owing to dehydration from emesis and constipation for 4 days, the latter relieved by barium enema. An abdominal x-ray film showed distended bowel loops. Two months later, emesis recurred with diarrhea and a low-grade fever. A stool sample was positive for rotavirus. Soy-based formula was administered. At 3 months of age, symptoms recurred with abdominal pain. Distended bowel loops were noted on abdominal x-ray film. He responded to volume resuscitation and broad spectrum antibiotics. At 5½ months of age, he had recurrent dehydration and foul-smelling stools. His white blood cell count was 50 × 109/L with a shift to the left.