BMJ Case Reports 2018; doi:10.1136/bcr-2017-223314
  • Unusual association of diseases/symptoms

Acute glomerulonephritis secondary to Streptococcus anginosus

  1. Simone Chang3
  1. 1Internal Medicine, University of Florida College of Medicine, Jacksonville, Florida, USA
  2. 2College of Medicine, University of Florida, Gainesville, Florida, USA
  3. 3Hotz Children’s Hospital, Jackson Health Sysrem, Miami, Florida, USA
  1. Correspondence to Dr Satish Maharaj, satishsmaharaj{at}
  • Accepted 18 February 2018
  • Published 9 March 2018


Streptococcus anginosus is a clinically important pathogen that is emerging globally but remains poorly investigated. Here, we report the first case of acute glomerulonephritis resulting from infection with S. anginosus. Glomerulonephritis is typically caused by S. pyogenes and reports secondary to other strains including S. zooepidemicus and S. constellatus exist. Infection with S. anginosus in this patient was associated with acute nephritis (haematuria, oedema and hypertension), nephrotic syndrome and progressive azotemia. There was activation of the complement system. The presence of low C1q and elevated anti-C1q binding complexes points to a potential pathogenic role. Testing for streptococcal antigens was strongly positive. Emerging nephritogenic strains of S. anginosus present a significant health concern for both developed and developing countries.


  • Contributors SM and KS conceived the idea for the study. SM, KS and SC were directly involved in patient care. SM and SC collected the data and wrote the case report. KS and SC performed the literature review and prepared the supplementary material. All authors contributed to the discussion and approved the final draft of the manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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