Clinical History.—This 12½-year-old boy was seen because of dark urine. Eleven days prior to the present visit, he had sore throat and fever, for which he received penicillin. Five days later, he developed left flank pain and for three days had passed dark urine. There was no other significant history.
Physical Examination.—The patient was in no distress. His blood pressure was 100/60 mm Hg. There were no abnormal physical findings.
Laboratory.—The urine was loaded with erythrocytes, had a specific gravity of 1.016, and contained albumin (2+). The antistreptolysin O (ASL-O) titer was 250 Todd units (TU) and rose to 500 TU one week later. The erythrocyte sedimentation rate was 10 mm/hr (Westergren).
The clinical diagnosis was acute glomerulonephritis. The urine cleared within one week, at which time an excretory urogram was obtained.
Denouement and Discussion
Ureteral Jet Effect
The diagnosis of acute glomerulonephritis was made on the