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Glomerulonephritis Associated with Nonstreptococcal Infection Clinical Presentation

  • Author: James W Lohr, MD; Chief Editor: Vecihi Batuman, MD, FACP, FASN  more...
Updated: Apr 28, 2015


Presentation may vary from asymptomatic hematuria to a full-blown acute nephritic syndrome consisting of proteinuria, edema, hypertension, and renal failure.

  • Hematuria may be gross or microscopic.
  • Patients may have evidence of edema.
  • Patients may report fever, night sweats, and rigors.
  • Weight loss is a possible complaint.
  • Patients may report arthralgias.
  • Abdominal, chest, or back pain may be caused by a visceral abscess.
  • Patients may have history of shunt placement for hydrocephalus, or they may have a vascular graft that has become infected.
  • Patients with hepatitis B or C may have a history of intravenous drug abuse, needle stick injury, blood transfusions, or sexual promiscuity.
  • Patients with HIV infection may have history of intravenous drug abuse, hemophilia, history of blood transfusion from 1977-1985, unprotected sex with multiple partners, or tuberculosis.


Hypertension may be due to renal failure.

Edema due to nephrotic syndrome is unusual but can develop in as many as 30% of cases associated with shunt nephritis.

Rash may be maculopapular or purpuric.

Lymphadenopathy is a reported finding.

Patients may have hepatosplenomegaly.

Findings of subacute bacterial endocarditis (SBE) may include the following:

  • Heart murmur
  • Purpura
  • Roth spots
  • Janeway lesions


Infections with bacteria, viruses, protozoa, and helminths can cause postinfectious GN (PIGN).

  • Bacterial endocarditis: PIGN occurs more commonly in subacute rather than acute endocarditis. S aureus is now the most common pathogen recognized.[8]
  • Shunt nephritis: This may be associated with ventriculovascular, ventriculoperitoneal, peritoneovascular, or vascular shunts.[9]
  • Visceral abscesses: These may occur with abdominal, pulmonary, or retroperitoneal abscesses.
  • Syphilis
  • Hepatitis B[5]
  • Hepatitis C[5, 4]
  • Human immunodeficiency virus[5, 10, 6]
  • Cytomegalovirus
  • Parvovirus B19
  • Hantavirus
  • Malaria
  • Schistosomiasis[11]
  • Leishmaniasis
  • Filariasis
  • Hydatid disease
  • Toxoplasmosis
  • Aspergillosis
Contributor Information and Disclosures

James W Lohr, MD Professor, Department of Internal Medicine, Division of Nephrology, Fellowship Program Director, University of Buffalo State University of New York School of Medicine and Biomedical Sciences

James W Lohr, MD is a member of the following medical societies: American College of Physicians, American Heart Association, American Society of Nephrology, Central Society for Clinical and Translational Research

Disclosure: Partner received salary from Alexion for employment.


Quresh T Khairullah, MBBS, MD 

Quresh T Khairullah, MBBS, MD is a member of the following medical societies: American College of Physicians, American Society of Nephrology, International Society of Nephrology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Ajay K Singh, MB, MRCP, MBA Associate Professor of Medicine, Harvard Medical School; Director of Dialysis, Renal Division, Brigham and Women's Hospital; Director, Brigham/Falkner Dialysis Unit, Faulkner Hospital

Disclosure: Nothing to disclose.

Chief Editor

Vecihi Batuman, MD, FACP, FASN Huberwald Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Renal Section, Southeast Louisiana Veterans Health Care System

Vecihi Batuman, MD, FACP, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, International Society of Nephrology

Disclosure: Nothing to disclose.

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