S-c-a-r-y! Yes, the rapid downhill physical condition and dehydration are signs of an adrenal crisis. So is low blood pressure and low blood glucose. These THEN progress to seizures and coma (too low blood glucose, drowsiness or lethargy can indicate low blood glucose), and shock from low blood pressure ---- then heart failure, then most probably death. Regarding a physician telling an ill CAH child/parent "to bring the child in in the morning if not better", bah humbug. A CAH child can so quickly go into seizures, shock, coma, and death when ill (even within 6-8 hours). If your daughter exhibits any signs of dehydration, she should probably be at the hospital being given IV fluids just to be on the safe side. Dehydration can occur in CAH children who are getting enough fluids - these children can dehydrate solely because they aren't getting enough salt (salt is necessary to force fluid into the bodily cells as water follows salt - so water with no salt can still bring cellular dehydration on and you'll see no dehydration symptoms until the child is near the severely dehydrated stage. I'd watch her carefully through the night, sleeping with her if you can, giving her fluids all night. Too many of us have had a child die from CAH complications, including myself. A CAH child running a fever of 101 or above needs extra cortef, high fevers can be deadly for these children. Vomiting (with no fever even) can also be deadly.