Pneumococcal glomerulonephritis in a healthy child: a case report and literature review

Abstract

following respiratory symptoms, have rarely been described. (1,2) Herein, we present a previously healthy child who developed pneumococcal AGN following submandibular and cervical lymphadenitis complicated with respiratory problems, and in whom AGN was confirmed on blood culture. We also review the relevant literature. CA S E R E PO RTA previously healthy four-year-old boy presented to Hospital Kuala Lumpur, Malaysia, with a one-week history of fever and neck swelling. Two days prior to admission, he developed high fever, vomiting and diarrhoea, with poor oral intake and reduced urine output. On examination, the boy was lethargic, febrile (temperature at 39.9°C) and appeared ill. His pulse rate was 120 bpm, respiratory rate was 30 bpm and blood pressure was 98/46 mmHg (50th percentile for age, gender and height at 93/50 mmHg). The patient was noted to have bad dental penicillin (50,000 unit/kg/dose) and cefotaxime (50 mg/kg/dose) were commenced. Over the following 48 hours, the patient developed periorbital and leg oedema, with tea-coloured urine.The patient was subsequently treated for acute nephritis with fluid restriction, and put on a low-salt diet and close monitoring of daily fluid intake/urine output. His blood pressure remained stable throughout the course of hospitalisation.Despite being administered antibiotics, the patient's fever remained unresolved. After two weeks of hospitalisation, he developed bronchopneumonia with left pleural effusion that was confirmed on repeat chest radiography. A left pleural tap did not grow any organisms, but the effusion did not deteriorate.Pneumococcal glomerulonephritis in a healthy child: a case report and literature review ABSTRACT Pneumococcal glomerulonephritis is rarely described in the literature. We report a four-year-old boy who developed acute glomerulonephritis following pneumococcal bacteraemia and submandibular lymphadenitis, and review the published literature. Two weeks after developing acute glomerulonephritis, the patient developed bronchopneumonia with left pleural effusion. However, by the fourth week of admission, his renal function had normalised and lung involvement resolved.

Postinfectious Glomerulonephritis Associated with Pneumococcus and Influenza A Virus Infection in a Child: a Case Report and Literature Review

“…In most PIGNs associated with pneumococcal infection in children, nephritis develops within 1 week after fever onset, [2][3][4][5][7][8][9] whereas it develops within 1-2 weeks in PSGN cases.…”

“…1) PIGN caused by other pathogens, including Streptococcus pneumoniae, has been reported occasionally. [2][3][4][5][6][7][8][9] In this study, we report a case of PIGN associated with S. pneumoniae and influenza A virus infection in a 6-year-old Korean child and review the cases reported to date.…”

Pneumonia-Associated Acute Glomerulonephritis: Report of 2 Cases

“…1,2 The most commonly related agents are S. pneumoniae and M. pneumoniae , but other bacteria, virus and parasites have also been described. 1-5 The serotypes of S. pneumoniae described as nephritogenic are 5, 6B, 7, 9, 14, 15, and 17F. 1-5…”

Pneumococcal meningitis associated with glomerulonephritis: A case report

“…Haematu- ria, proteinuria, and elevated blood pressure indicated the development of nephritic syndrome in our patient. Cases of adults and children developing a clinically apparent pneumococcal disease and subsequently acute glomerulonephritis, have been previously described [39][40][41][42] . Streptococcus pneumoniae is now a recognized cause of postinfectious glomerulonephritis (PIGN).…”