2023-11-27 09:19:00
Dr. Manoon Leechawengwong, a physician specializing in respiratory system diseases Revealing the case of a healthy male patient. No congenital disease Falling off a bicycle There were bleeding wounds on the left knee and elbow. Finally, acute nephritis was found to be caused by a streptococcus infection.
Today (27 Nov.) Facebook page “Dr. Manoon Leechawengwong” or Dr. Manoon Leechawengwong, a physician specializing in respiratory system diseases. Vichaiyut Hospital has come out and posted information by stating that “The patient is a 47-year-old male, normally healthy. No chronic diseases. On October 25, 2023, he fell off his bicycle. There were bleeding wounds on the left knee and elbow. Later, the wound became infected. After receiving penicillin antibiotics, the infected wound improved.
On October 30, 2023, blood was drawn for kidney creatinine Cr 0.78. Kidney function was 100% normal. On November 16, there was a headache, swollen legs, vomiting, little urine output. Weight increased 4 kilograms, high blood pressure 190/105, the wound on the left elbow and knee improved and scabbed over (see picture). An ultrasound of the kidney was done for normal size. Urine test showed protein 3+, blood 2+, red blood cells 20-30 cells/HPF, blood test BUN 62, Cr 2.38, kidney function decreased to 33%, Uric acid 13.6 high.
Anti-DNase B 2,560 (normal value 0-200) ASO 122.6 (normal value
Conclusion: The patient has acute glomerulonephritis caused by streptococcal infection (Acute post streptococcal glomerulonephritis) on the skin around the elbows and knees. The skin infection occurred about 3 weeks before the glomerulonephritis, 10 days later after the glomerulonephritis. On November 26, the patient was much better, no headaches, and blood pressure improved after taking antihypertensive medication. Urine output improved, swelling subsided, blood tests for kidney function improved, BUN 23, Cr 1.23, kidney function increased to 73%, Uric acid decreased to 9.8.
Most cases of acute nephritis after streptococcal infection clear up on their own within 2-4 weeks. Acute nephritis after streptococcal infection mostly occurs in children. Occurs after infection with group A beta hemolytic streptococcus, a type of nephritogenic strain, in the throat and skin. This disease is very rare in adults over 18 years of age, occurring in less than 1 in 100,000.”
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