A 20-year-old woman, who works at a stable, presented to her General Practitioner with a 5-day history of increasing facial swelling and right loin pain. She also complained of reduced urine output for the past two days. She is normally fit and well. She has been unwell for around 3 weeks starting with severe tonsillitis. She was prescribed a 5-day course of penicillin. Tonsillitis cleared but she continued to feel quite tired and lethargic.
Five days ago, she noticed that her face was a little swollen when she got out of bed in the morning. Her legs became swollen and her urine color became dark – as dark as Cola . She is also passing much smaller volumes of urine than usual. She tried to drink more water to dilute the urine but this has only led to more ankle swelling. Other than the penicillin given by her GP, she has not started any new medicines. But she takes the oral…
