Dr Xavier Flannery

Paediatrician
567 Church St Springvale 3171

19 March 2024

Dear Dr Flannery

Re: Peter Ludovic, aged 8 years

I am writing to refer Peter, an 8-year-old boy who presented with signs and symptoms consistent
with the diagnosis of post streptococcal nephritis, for your evaluation.

Initially, accompanied by his mother, he presented to me on 22/02/06 with the complaints of fever,
sore throat and hoarseness of voice. On examination, exudative Tonsillitis was found, and he was
treated with penicillin v.

On 15/01/07, mother came with the complaint of brown colour urine for previous 4 days. Please
note, on urine examination macroscopic haematuria was detected. Provisional diagnosis of post
streptococcal nephritis and Urinary tract infection was made. Relevant blood and urine samples were
sent and follow up was ensured after 2 days.

Today, Peter came to my clinic with no symptoms, but his blood pressure has been on higher side
110/90. Laboratory reports revealed increased urea and creatinine. In addition, his Anti streptolysin-
O Titre is significantly raised. In his mid-stream urine sample, red blood cells of renal origin have
been found.

I believe, Peter needs your assessment to rule out the possibility of post streptococcal nephritis with
early onset renal failure.

Should you have any further questions, do not hesitate to contact me.

Yours sincerely

Doctor