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Acute glomerulonephritis associated with streptococcus pyogenes with concomitant spread of streptococcus constellatus in four rural families
Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nephrology. Östergötlands Läns Landsting, Centre for Medicine, Department of Nephrology UHL.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Clinical Microbiology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
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2005 (English)In: Uppsala Journal of Medical Sciences, ISSN 0300-9734, Vol. 110, no 3, 217-231 p.Article in journal (Refereed) Published
Abstract [en]

We studied history, renal histopathology and microbiology of an epidemic of acute glomerulonephritis associated with throat infections and uncommon culture results in four neighbour families. A 40-year-old man (index patient) was referred to a university hospital for dialysis and kidney biopsy due to a suspected acute glomerulonephritis. An acute tonsillitis had preceded the condition. Penicillin treatment had been started four days before the discovery of renal failure. Throat swabs were positive for β-hemolytic streptococci, group C (GCS). GCS were also found in throat cultures from his wife and two of their children. The bacteria were typed as Streptococcus constellatus. A third child had S. constellatus expressing Lancefield antigen group G. A neighbour and two of his children fell ill the following week with renal involvement. Throat swabs from both these children were positive for S. constellatus. His third child had erythema multiforme and S. constellatus in the throat while a fourth child had β-hemolytic streptococci group A, Streptococcus pyogenes. Kidney biopsies on the index patient and his neighbour showed an acute diffuse prolipherative glomerulonephritis compatible with acute post-streptococcal nephritis and microbiological analysis of renal tissue revealed in both cases S. pyogenes and S. constellatus. The families had had much contact and had consumed unpasteurized milk from our index patient's farm. In four of seven persons in two additional neighbouring families S. constellatus was found in throat swabs during the same month while two persons carried Streptococcus anginosus expressing the Lancefield C antigen. In conclusion spread of S. constellatus coincided with the occurrence of four cases of acute glomerulonephritis. The two biopsied patients had both S. pyogenes and S. constellatus present in renal tissue. The epidemic either suggested that the outbreak of glomerulonephritis was due to S. pyogenes but coincided with the transmission and colonization of S. constellatus or that the S. constellatus strains were highly pathogenic or nephritogenic and that this organism can be transmitted in such cases.

Place, publisher, year, edition, pages
2005. Vol. 110, no 3, 217-231 p.
Keyword [en]
Glomerulonephritis, S. pyogenes, streptococci group C, streptococci group G, S. constellatus
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-33454Local ID: 19475OAI: diva2:254277
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2011-01-12

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Almroth, GabrielSörén, LarsHultman, Per
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Faculty of Health SciencesNephrologyDepartment of Nephrology UHLClinical MicrobiologyDepartment of Clinical MicrobiologyMolecular and Immunological PathologyDepartment of Clinical Pathology and Clinical Genetics
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Uppsala Journal of Medical Sciences
Medical and Health Sciences

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