Clinical Case 1

Peter is a 7-year-old boy who is on holiday in the UK with his parents. He has developed a febrile illness associated with coryzal symptoms. Parents have been giving both paracetamol and ibuprofen for fever. It is now 7pm; they report he has not passed urine since 6 am this morning.

On further questioning, they tell you he had been diagnosed with Henoch Schonlein purpura (HSP) 1 months ago in his home country. He presented with a typical purpuric rash and joint pain and he was managed with oral analgesia. Symptoms resolved over two weeks. They report that they had follow up arranged for urine dip testing, but missed their last appointment 1 week ago after his symptom had resolved.

On examination you find Jack appears well, has coryzal symptoms with evidence of an upper respiratory tract infection, and is not clinically dehydrated.