Concurrent Postinfectious Glomerulonephritis and Retropharyngeal Abscess in 12 Year Boy: A Case Report

Abstract

Introduction: Post-streptococcal glomerulonephritis (PSGN) is a classic immune-mediated renal complication that typically arises 1 - 2 weeks after a streptococcal throat infection. While it is most commonly observed following pharyngitis or skin infections in children, its occurrence in association with deep neck infections, such as retropharyngeal abscess, is extremely rare. Case Presentation: We report a rare case of a 12-year-old boy with type 1 diabetes mellitus (DM1) who presented with edema and signs of acute glomerulonephritis (AGN) one week after symptoms of an upper respiratory tract infection. On examination, he had fever, dysphagia, cervical lymphadenopathy, and imaging confirmed a retropharyngeal abscess. Laboratory findings revealed microscopic hematuria, proteinuria, elevated antistreptolysin O (ASO) titers, low complement (C3) levels, and elevated inflammatory markers, supporting the diagnosis of PSGN. The patient was treated with broad-spectrum intravenous antibiotics and supportive therapy, resulting in complete resolution of the infection and normalization of renal findings within four weeks. Conclusions: This case highlights an unusual presentation of PSGN in association with a retropharyngeal abscess in an older child. Clinicians should maintain a high index of suspicion for post-infectious glomerulonephritis in children presenting with acute kidney injury and deep neck infections, even beyond the typical age range for retropharyngeal abscesses.