Glomerulonephritis Associated with Nonstreptococcal Infection Clinical Presentation

Updated: Mar 19, 2018
  • Author: James W Lohr, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Presentation

Physical

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. Hepatosplenomegaly may be palpable.

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

  • Heart murmur
  • Purpura
  • Roth spots
  • Janeway lesions
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History

The presentation in patients with postinfectious glomerulonephritis (PIGN) 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 and edema may be present.  Patients may report fever, night sweats, and rigors. Weight loss is a possible complaint and 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, receipt of blood transfusion from 1977-1985, unprotected sex with multiple partners, or tuberculosis.

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