Acute poststreptococcal glomerulo-nephritis in general practice: the contribution of infection to its onset and course

Abstract

SUMMARYTwenty-one patients considered to have acute poststreptococcal glomerulo-nephritis were encountered during 35 years of general practice. In ten of them good evidence of active streptococcal infection at the time of discovery of nephritis was recorded. The more complete the data the more convincing was the evidence of active infection.In over half of those whose urines were routinely cultured pathogens were isolated and over a third were treated for infection of the urinary tract. Such infections were associated with adverse effects and prolonged illness.As compared with children, adults in general had a longer history of ill-health, were less likely to present with acute infections and more likely to have urinary tract infections and prolonged illness.Vigorous antistreptococcal treatment was followed by rapid recovery in those patients so treated whose illnesses were not complicated by urinary tract infections.Concurrent streptococcal infection and secondary infection of the urinary tract may contribute more to the onset of acute poststreptococcal glomerulo-nephritis and to its course than is currently believed.

Proteinuria is associated with persistence of antibody to streptococcal M protein in Aboriginal Australians

“…Group A streptococcal infections of the throat or skin in childhood can be followed by acute glomerulonephritis, particularly in poor social circumstances where streptococcal infections are endemic [1]. In affluent populations, acute post-streptococcal glomerulonephritis (APSGN) has virtually dis-appeared [2] since the 1950s following improvements in living conditions and availability of penicillin ; deaths due to chronic renal failure have also declined markedly [3].…”