Epidemic glomerulonephritis due to Streptococcus zooepidemicus in Nova Serrana, Brazil

Epidemic glomerulonephritis due to Streptococcus zooepidemicus in Nova Serrana, Brazil

Author Sesso, Ricardo de Castro Cintra Autor UNIFESP Google Scholar
Pinto, Sergio Wyton Lima Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Hosp Sao Joao de Deus
Abstract Background. in 1998, there was a large outbreak of acute glomerulonephritis in Nova Serrana, Brazil, caused by group C Streptococcus zooepidemicus. This article reviews the characteristics of the outbreak and some aspects of the patients' follow-up.Methods. We describe clinical characteristics of patients with acute nephritis. Using case-control studies, we identified the source of infection. Cultures of oropharyngeal swabs from patients were performed. of 135 patients identified in 1998, available patients were reexamined in a prospective study after 2 and 5 years.Results. Lancefield group C S. zooepidemicus was identified as the causative organism and linked to the consumption of cheese produced from unpasteurized milk. of the original group of 134 patients, 4 died in the acute phase and 5 (3.7%) required chronic dialysis. After 2 years, of the 69 cases reevaluated, 94% were adults (mean +/- standard error age: 39 +/- 2 years); we found arterial hypertension in 42% (N = 27/64) of the patients, reduced creatinine clearance (< 80 mL/min/1.73 m(2)) in 30% (N = 20/67), and increased microalbuminuria (> 20 mu g/min) in 34% (N = 22/65). Preliminary data at 5-year follow-up suggest that the percentage of patients with creatinine clearance lower than 60 mL/min increased from 9% to 15%.Conclusion. This article highlights the dangers of consuming unpasteurized dairy products. Follow-up of patients with epidemic poststreptococcal glomerulonephritis due to S. zooepidemicus show that a considerable proportion present hypertension, reduced renal function, and increased microalbuminuria.
Keywords poststreptococcal glomerulonephritis
epidemic nephritis
acute nephritis
Streptococcus zooepidemicus
follow-up
Language English
Date 2005-08-01
Published in Kidney International. Oxford: Blackwell Publishing, v. 68, p. S132-S136, 2005.
ISSN 0085-2538 (Sherpa/Romeo, impact factor)
Publisher Blackwell Publishing
Extent S132-S136
Origin http://dx.doi.org/10.1111/j.1523-1755.2005.09722.x
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000230896100023
URI http://repositorio.unifesp.br/handle/11600/28392

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