A 2-year-old boy from rural Uttar Pradesh is brought to the pediatric ward with a 6-month history of poor weight gain and recurrent infections. On examination, he weighs 9 kg (expected 12–14 kg for age), has generalized muscle wasting, loss of subcutaneous fat, and sparse, thin hair that plucks easily. His abdomen is distended but soft, and liver edge is palpable 2 cm below the costal margin. Laboratory studies show serum albumin 2.1 g/dL, hemoglobin 8.5 g/dL, and lymphocyte count 800/μL. Which clinical form of protein-energy malnutrition does this presentation most closely represent?