Epidemic glomerulonephritis due to Streptococcus zooepidemicus in Nova Serrana, Brazil

• Autor(a) principal: Sesso, Ricardo de Castro Cintra [UNIFESP]
• Data de Publicação: 2005
• Outros Autores: Pinto, Sergio Wyton Lima
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/0013000010z9z
• Texto Completo: http://dx.doi.org/10.1111/j.1523-1755.2005.09722.x; http://repositorio.unifesp.br/handle/11600/28392
• topic: poststreptococcal glomerulonephritis; epidemic nephritis; acute nephritis; Streptococcus zooepidemicus; follow-up

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.