Hospital staff did not spot boy's life-threatening illness, inquest told.

Hospital staff did not spot an eight-year-old boy's rare but life-threatening illness in the hours following his admission, an inquest has heard.

Callum Cartlidge, described by his headteacher, as a "polite, friendly and smiley" boy died after suffering a cardiac arrest on March 3.

A trainee doctor who saw Callum at Worcestershire Royal Hospital during an admission on March 2, 2017, said she suspected "appendicitis", or "inflamed lymph nodes" or possibly a "urinary tract infection".

At the start of a five-day inquest hearing into his death on Monday, Dr Nicola Goodfellow was asked about whether she knew of Addison's Disease, replying: "It's extremely rare."

Richard Grimshaw, the Cartlidge family's barrister, then asked about the linked potentially life-threatening condition known as adrenal Addisonian crisis.

He asked if she had considered whether Callum's "hypoglycaemic episode", which had occurred in the hours before his hospital admission, had led her to think there might be some other under-lying explanation to Callum's symptoms.

She replied: "There was a common and plausible reason for him to have that (hypo-glycaemic episode) because he had been vomiting and not eating.

"There was no reason to suggest he had any other ongoing and underlying condition."

Worcestershire Coroner's Court heard Callum's health took a turn for the worse in January 2017, weeks before his death.

On February 28, he was diagnosed with suspected tonsillitis by a nurse at his GP's surgery, and prescribed antibiotics, which seemed to clear it up.

But he was brought back to surgery by his mother Stacey Cartlidge on March 2, reporting he had been "vomiting" and suffering "abdominal pain", according to his GP.

Earlier that day Creena Bullock, a health worker on a home visit for Callum's siblings, saw the youngster looking "pale, gaunt and lethargic" and "very thin".

She added that if a doctor's appointment had not already been booked, "I'd have made an emergency appointment for him that day".

Arriving at surgery Dr Ikram ul-Haq, of Winyates Health Centre, said: "On examination, he was clinically dehydrated, with sunken eyes, and had a dry mucus membrane.

"He was floppy, very lethargic."

Callum was running a temperature and had low blood sugar, which was treated with glucose tablets.

"I called 999 as Callum did not look well," added the doctor.

Describing the youngster, headteacher, Jacqueline Harris, of Matchborough First School Academy, said: "He had always got something to say, he was polite, and friendly, and smiley."

But she said that after his return to school following the winter break, in January 2017, Callum had several periods off school.

The youngster had initially seen another GP in Redditch, Worcestershire, on January 13, but the doctor said "symptoms were most likely of post viral response to recent gastro-enteritis".

Mrs Harris said there was a stark contrast to the boy she knew before Christmas 2016, and the period leading to his death

She said: "It wasn't the same child.

"He had just got no energy, just ill the whole time - he just never got his spark back."

On admission to Worcestershire Royal Hospital from the GP, on March 2, he was seen at 3.45pm by staff nurse Zara Oliver, who triaged the youngster and recalled him "looking pale and dehydrated".

It was proposed to move him to the hospital's Riverbank children's ward, she said.

But this was not completed until 6.30pm, in part because it was a "busy" night at A&E and the nurse had two other children to transfer, before Callum, the court heard.

Mr Grimshaw asked Miss Oliver: "It was your workload that meant you couldn't get him down (to Riverbank)?

"You didn't have the resources?"

She replied: "I had three children to go to the Riverbank (ward) all at the same time."

Callum was discharged from hospital but died less than 24 hours later.

The inquest continues.