Epidemic glomerulonephritis due to Streptococcus zooepidemicus in Nova Serrana, Brazil.
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 microg/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.[1]References
- Epidemic glomerulonephritis due to Streptococcus zooepidemicus in Nova Serrana, Brazil. Sesso, R., Wyton, S., Pinto, L. Kidney Int. Suppl. (2005) [Pubmed]
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