Fast Five Quiz: Streptococcal Infection Clinical Keys

Michael Stuart Bronze, MD


February 18, 2021

A history suggestive of preceding streptococcal infection may include pharyngitis, tonsillitis, or pyoderma. This is the sine qua non for the diagnosis of acute poststreptococcal glomerulonephritis.

Dark urine (brown-, tea-, or cola-colored) is often the first clinical manifestation of acute poststreptococcal glomerulonephritis. Dark urine is caused by hemolysis of red blood cells that have penetrated the glomerular basement membrane and passed into the tubular system.

A latent period always occurs between the streptococcal infection and the onset of signs and symptoms of acute glomerulonephritis. In general, the latent period is 1-2 weeks after a throat infection and 3-6 weeks after a skin infection. The onset of signs and symptoms at the same time as pharyngitis is more likely to be IgA nephropathy rather than acute poststreptococcal glomerulonephritis.

Periorbital edema is typical. The onset of puffiness of the face or eyelids is sudden. It is usually prominent upon waking up and, if the patient is active, tends to subside at the end of the day.

Read more about poststreptococcal glomerulonephritis.


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