Red Eyes and Renal Insufficiency in an 8-year-old Boy

摘要

A previously healthy 8-year-old boy presents with 2 weeks of poor oral intake, persistently red eyes, intermittent nausea, and 1 day of pallor. His parents report that he fatigues more easily with playing but deny fever, night sweats, weight loss, eye pain, pruritis of eyes, eye discharge, eyelid swelling, vision changes, rhi-norrhea, cough, sore throat, vomiting, abdominal pain, diarrhea, or joint pain. He has not recently traveled or been ill, and there are no reported sick contacts, insect bites, or animal exposures. Vital signs are notable for normal temperature, heart rate of 119 beats/min, respiratory rate of 22 breaths/min, and blood pressure of 125/93 mm Hg. He is in no distress and has normal cardiovascular and respiratory examination findings. Abdominal examination reveals a soft abdomen with normal bowel sounds, no tenderness to palpation, and no hepatosplenomegaly. Eye examination is notable for bilateral conjunctival injection with normal-appearing eyelids, no ocular discharge, round pupils that are equally reactive to light, and full extra-ocular movements. He has normal joint range of motion without tenderness