Glomerular Greta — Post-Streptococcal Glomerulonephritis: The Tea-Colored Urine After the Sore Throat
A sore throat two weeks ago, now smoky urine, puffy eyes and a climbing blood pressure
The sore throat healed last week — now Greta's urine looks like tea and her eyes are puffy every morning.
Greta's kidneys pay for a strep infection her throat already forgot. One to two weeks after a streptococcal throat or skin infection, immune complexes lodge in the glomeruli and inflame them. The classic picture in a school-age child: dark tea- or cola-colored urine from red blood cells leaking through, puffy eyelids especially in the morning, mild to moderate high blood pressure, and decreased urine output. Labs show red blood cells and casts in the urine, low complement C3, elevated ASO titer, and mild rises in BUN and creatinine. Most children recover fully with supportive care: monitor blood pressure, restrict sodium and fluids during the acute phase, and finish the antibiotic course for the original infection.
Read Glomerular Greta's full story →The story arc
The setup
A 7-year-old had strep throat two weeks ago and finished only half the antibiotic course.
The turn
Her mother notices her urine looks like cola and her eyes are swollen each morning.
The crisis
Her blood pressure is 138/90, her urine output has fallen, and crackles are appearing in her lungs.
The save
Greta rests, sodium and fluids are restricted, her pressure is tracked, and within weeks her urine clears.
NCLEX study section — Post-Streptococcal Glomerulonephritis: The Tea-Colored Urine After the Sore Throat
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Gastrointestinal & Renal
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