Does he look puffy to you?

What is your diagnosis at this stage?

A week later, Patrice is brought back in as his eyes are very puffy. Since you last saw the baby, he has had no further nose bleeding but his eyelids have become more swollen.

Three days after his last CED attendance, GP prescribed chloramphenicol eye drops were prescribed for a presumed conjunctivitis. However, his eyes kept getting increasingly puffy.

You examine Patrice again. He still appears well in himself; however, you notice that his whole face looks quite puffy and he has oedema up to his knees.

Respiratory and cardiovascular exams are unchanged and he has no hepatomegaly.

The father is concerned about a reaction or side effect to the chloramphenicol.

You note he has 4+ protein in his urine sample.

What is your diagnosis?

You reflect on Patrice’s 2 presentations and are glad that he was brought back to CED. You talk to senior colleagues and wonder if the baby’s diagnosis may have been picked up sooner, they think not.

Baby’s father is keen to understand more about his son’s diagnosis including what will happen next and what this means for Patrice’s future.

Which of the following answers best describes the next steps in investigating and managing Patrice appropriately?