A Unique Presentation and Clinical Course of Poststreptococcal Glomerulonephritis Following Recent Influenza...

Poststreptococcal glomerulonephritis (PSGN) is a well-characterized immune-mediated disease that typically follows group A streptococcal infection of the pharynx or skin. We present the case of a seven-year-old male who developed PSGN following a recent influenza virus infection without a clear history of preceding streptococcal illness. The patient presented with nausea, vomiting, edema, and hypertension, with laboratory findings including microscopic hematuria, proteinuria, decreased complement C3 levels, and elevated anti-streptococcal antibodies. His clinical course was notable for persistent hypertension requiring escalation of care to the pediatric ICU (PICU). Supportive management with antihypertensives, diuretics, and fluid restriction resulted in clinical improvement. This report highlights an atypical presentation and clinical course of PSGN, emphasizing the importance of maintaining a high index of diagnostic suspicion even in the absence of classic antecedent streptococcal symptoms and in the setting of a recent viral infection.