Signs and symptoms
In most cases, the first sign of nephritis is the child’s producing urine that is a smoky color or brownish-red and tinged with blood. The child may have puffy eyes and run a fever of 38.3°C to 38.9°C for several days. In severe cases, the illness produces high fever, headache, vomiting, high blood pressure, and convulsions; urination ceases almost completely, and the urine the child does produce contains a lot of blood. An analysis of urine will confirm the diagnosis. Positive cultures of nose and throat secretions for the strep bacteria support the diagnosis.
Home care
As mentioned earlier, most cases of nephritis are mild and don’t attract attention or require treatment. If the symptoms are severe enough to be recognized, however, do not attempt home treatment; the child should see a doctor.
You should be aware that nephritis most often follows strep impetigo and can follow a strep throat whether or not the strep throat has been treated with antibiotics.
Medical treatment
In a case of suspected nephritis the doctor will examine the child thoroughly and take the child’s blood pressure. The doctor may take a throat culture to identify a strep infection, and order urine and blood tests. If the child does have nephritis the doctor will usually prescribe penicillin or erythromycin for ten days. The doctor will monitor the child’s blood and urine until they are normal again. The child should stay in bed only during the acute phase of the disease. A severe case may require the child to be hospitalized for observation and treatment of high blood pressure or convulsions. In some cases the doctor will prescribe continued medication, sometimes for several months both while the child is recovering and afterward.
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