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A previously healthy 32-year-old man presented to the hospital with cough, sore throat, facial swelling and intermittent fever for 1 week. Initial physical examination revealed blood pressure of 160/98 mm Hg, erythematous throat, bilateral periorbital swelling, right basilar crackles and no neurological abnormalities. Laboratory tests were remarkable for leucocytosis (13 320 cell/mm3), hyperkalaemia (5.2 mmoL/L), azotemia (Cr 2 mg/dL), haematuria (urine red blood cells of 50–100 cells/high power field) and proteinuria (urine protein/creatine ratio >7 g/gCr). Chest X-ray showed right lower lobe pneumonia with parapneumonic effusion. The patient was admitted for community-acquired pneumonia, non-oliguric acute kidney injury and nephritic syndrome. Later, antistreptolysin O was found to be elevated …
Contributors All the authors participated in the direct care of the case and identified the case. HAR, JW and CS wrote up the case with literature review. JH supervised the whole process and reviewed the final manuscript with all the authors.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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