Acute post-streptococcal glomerulonephritis with bilateral pleural effusion in a 12-year-old child in rural area: A case report

Background: Nephritic syndrome is a group of symptoms such as hematuria, hypertension, oliguria and edema. The most common cause of acute nephritic syndrome in children is acute glomerulonephritis after streptococcal infection. Case Presentation: A 12-year-old child came to the ER with shortness of breath for 3 days and swelling of the face. There was no history of fever or diarrhea. The patient had a history of itching of the feet 2 weeks earlier. Vital signs found blood pressure of 160/120 mmHg and edema was found on the face especially in the eyelids. Urine examination found a high number of leukocytes and erythrocytes and there was albumin +2 in the urine. Examination of kidney function showed an increase in urea and creatinine. Chest X-ray examination showed pulmonary edema and bilateral effusion. ASTO titer examination obtained a level of 200 IU/ml. The patient was given therapy in the form of antihypertensives, antibiotics and corticosteroids. After 1 week of hospitalization, the blood pressure target and clinical improved, the patient was able to leave the hospital, checked into the polyclinic to continue treatment and evaluated urine examination of kidney function every 2 weeks. Summary: Acute nephritic syndrome is a disease that is rarely found in pediatric patients, most of the causes are acute glomerulonephritis after streptococcal infection with clinical manifestations in the form of throat infection or skin infection in the form of impetigo. With proper diagnosis and management, this disease can be cured with perfect healing, but some cases can occur acute kidney failure so that monitoring is needed.