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Acute Glomerulonephritis and Streptococcal Skin Lesions in Eskimo Children

Acute Glomerulonephritis and Streptococcal Skin Lesions in Eskimo Children Abstract • Poststreptococcal acute glomerulonephritis often follows impetigo and can occur in epidemics. From 1975 through 1977, an epidemic of poststreptococcal acute glomerulonephritis occurred in Alaska. Fifty children required hospitalization, while 25 less seriously ill children were treated as outpatients. Sixty-seven percent of these 75 children had direct evidence of recent skin infections. Serotypes 49-14 and NT-14 were the most common streptococcal isolates. In villages in the epidemic area, approximately 15% of children had impetigo and more than 60% of lesions cultured were positive for group A streptococci. Impetigo rates in the epidemic area were similar to those found in nonepidemic areas. However, the introduction of the nephritogenic streptococcal serotypes not recently present in this population apparently led to the development of the epidemic. (Am J Dis Child 134:681-685, 1980) References 1. Ferrieri P, Dajani AS, Wannamaker LW, et al: Natural history of impetigo: I. Site sequence of acquisition and familial patterns of spread of cutaneous streptococci . J Clin Invest 51:2851-2862, 1972.Crossref 2. Dillon HC Jr: Impetigo contagiosa: suppurative and non-suppurative complications: I. Clinical, bacteriologic, and epidemiologic characteristics of impetigo . Am J Dis Child 115:530-541, 1968.Crossref 3. Anthony BF, Kaplan EL, Wannamaker LW, et al: Attack rates of acute nephritis after type 49 streptococcal infection of the skin and of the respiratory tract . J Clin Invest 48:1697-1704, 1969.Crossref 4. Poon-King T, Mohammed I, Cox R, et al: Recurrent epidemic nephritis in South Trinidad . N Engl J Med 277:728-733, 1967.Crossref 5. Bjos G, Juhlin I, Moller H: Bacteriology and urinary examination in impetigo contagiosa . Acta Derm Venereol 53:481-486, 1973. 6. Edwards EA: Protocol for micro antistreptolysin O determinations . J Bacteriol 87:1254-1255, 1964. 7. Klein GG, Baker CN, Addison BV, et al: Micro test for streptococcal anti-deoxyribonuclease B . Appl Microbiol 18:204-206, 1969. 8. Ayoub EM, Wannamaker LW: Evaluation of the streptococcal deoxyribonuclease B and diphosphopyridine nucleotidase antibody tests in acute rheumatic fever and acute glomerulonephritis . Pediatrics 29:527-538, 1962. 9. Dillon HC Jr, Avery MS: Streptococcal immune responses in nephritis after skin infection . Am J Med 56:333-346, 1974.Crossref 10. Redys JJ, Hibbard EW, Borman EK: Improved dry-swab transportation for streptococcal specimens . Public Health Rep 83:143-149, 1968.Crossref 11. Lancefield RC: A serological differentiation of human and other groups of streptococci . J Exp Med 57:571-595, 1933.Crossref 12. Moody MD, Padula DL, Hall CT: Epidemiologic characterization of group A streptococci by T-agglutination and M-precipitation tests in the Public Health Laboratory . Health Lab Sci 2:149-162, 1965. 13. Kaplan EL, Anthony BF, Chapman SS, et al: Epidemic acute glomerulonephritis associated with type 49 streptococcal pyoderma: I. Clinical and laboratory findings . Am J Med 48:9-27, 1970.Crossref 14. Lasch EE, Frankel V, Vardy PA, et al: Epidemic glomerulonephritis in Israel . J Infect Dis 124:141-147, 1971.Crossref 15. Anthony BF, Kaplan EL, Wannamaker LW, et al: The dynamics of streptococcal infections in a defined population of children: Serotypes associated with skin and respiratory infections . Am J Epidemiol 104:652-666, 1976. 16. Nelson KE, Bisno AI, Waytz P, et al: The epidemiology and natural history of streptococcal pyoderma: An endemic disease of the rural southern United States . Am J Epidemiol 103:270-283, 1976. 17. Ortiz JS, Finklea JF, Potter EV, et al: Endemic nephritis and streptococcal infections in South Trinidad . Arch Intern Med 126:640-646, 1970.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1980.02130190049013
Publisher site
See Article on Publisher Site

Abstract

Abstract • Poststreptococcal acute glomerulonephritis often follows impetigo and can occur in epidemics. From 1975 through 1977, an epidemic of poststreptococcal acute glomerulonephritis occurred in Alaska. Fifty children required hospitalization, while 25 less seriously ill children were treated as outpatients. Sixty-seven percent of these 75 children had direct evidence of recent skin infections. Serotypes 49-14 and NT-14 were the most common streptococcal isolates. In villages in the epidemic area, approximately 15% of children had impetigo and more than 60% of lesions cultured were positive for group A streptococci. Impetigo rates in the epidemic area were similar to those found in nonepidemic areas. However, the introduction of the nephritogenic streptococcal serotypes not recently present in this population apparently led to the development of the epidemic. (Am J Dis Child 134:681-685, 1980) References 1. Ferrieri P, Dajani AS, Wannamaker LW, et al: Natural history of impetigo: I. Site sequence of acquisition and familial patterns of spread of cutaneous streptococci . J Clin Invest 51:2851-2862, 1972.Crossref 2. Dillon HC Jr: Impetigo contagiosa: suppurative and non-suppurative complications: I. Clinical, bacteriologic, and epidemiologic characteristics of impetigo . Am J Dis Child 115:530-541, 1968.Crossref 3. Anthony BF, Kaplan EL, Wannamaker LW, et al: Attack rates of acute nephritis after type 49 streptococcal infection of the skin and of the respiratory tract . J Clin Invest 48:1697-1704, 1969.Crossref 4. Poon-King T, Mohammed I, Cox R, et al: Recurrent epidemic nephritis in South Trinidad . N Engl J Med 277:728-733, 1967.Crossref 5. Bjos G, Juhlin I, Moller H: Bacteriology and urinary examination in impetigo contagiosa . Acta Derm Venereol 53:481-486, 1973. 6. Edwards EA: Protocol for micro antistreptolysin O determinations . J Bacteriol 87:1254-1255, 1964. 7. Klein GG, Baker CN, Addison BV, et al: Micro test for streptococcal anti-deoxyribonuclease B . Appl Microbiol 18:204-206, 1969. 8. Ayoub EM, Wannamaker LW: Evaluation of the streptococcal deoxyribonuclease B and diphosphopyridine nucleotidase antibody tests in acute rheumatic fever and acute glomerulonephritis . Pediatrics 29:527-538, 1962. 9. Dillon HC Jr, Avery MS: Streptococcal immune responses in nephritis after skin infection . Am J Med 56:333-346, 1974.Crossref 10. Redys JJ, Hibbard EW, Borman EK: Improved dry-swab transportation for streptococcal specimens . Public Health Rep 83:143-149, 1968.Crossref 11. Lancefield RC: A serological differentiation of human and other groups of streptococci . J Exp Med 57:571-595, 1933.Crossref 12. Moody MD, Padula DL, Hall CT: Epidemiologic characterization of group A streptococci by T-agglutination and M-precipitation tests in the Public Health Laboratory . Health Lab Sci 2:149-162, 1965. 13. Kaplan EL, Anthony BF, Chapman SS, et al: Epidemic acute glomerulonephritis associated with type 49 streptococcal pyoderma: I. Clinical and laboratory findings . Am J Med 48:9-27, 1970.Crossref 14. Lasch EE, Frankel V, Vardy PA, et al: Epidemic glomerulonephritis in Israel . J Infect Dis 124:141-147, 1971.Crossref 15. Anthony BF, Kaplan EL, Wannamaker LW, et al: The dynamics of streptococcal infections in a defined population of children: Serotypes associated with skin and respiratory infections . Am J Epidemiol 104:652-666, 1976. 16. Nelson KE, Bisno AI, Waytz P, et al: The epidemiology and natural history of streptococcal pyoderma: An endemic disease of the rural southern United States . Am J Epidemiol 103:270-283, 1976. 17. Ortiz JS, Finklea JF, Potter EV, et al: Endemic nephritis and streptococcal infections in South Trinidad . Arch Intern Med 126:640-646, 1970.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Jul 1, 1980

References