Tropical acute rheumatic fever and associated streptococcal infections compared with concurrent acute glomerulonephritis

Ninety-three patients with acute rheumatic fever and 195 patients with acute glomerulonephritis were observed in Trinidad during an outbreak of scabies with a high incidence of secondary streptococcal infections. Clinical and laboratory manifestations of ARF were the same as those seen in temperate zones, except that antistreptolysin O titers were less markedly increased. The patients with ARF were similar to those with AGN in respect to sex, race, location of residence, and living conditions, but were older and had markedly fewer skin infections. Currently prevalent nephritogenic streptococcal strains never were isolated from patients with ARF even when M55 streptococci appeared and led to an epidemic of AGN.(AU)

Epidemic acute nephritis associated with re-appearance of type 55 streptococcus - abstract

A large epidemic of acute glomerulonephritis occurred in South Trinidad in 1971, the fourth since 1952. Seven hundred and forty-three (743) cases were admitted to the San Fernando hospital during the year. After a high endemic period during the first 5 months, an epidemic broke out in June, 1971 and 598 patients were admitted with acute glomerulonephritis from June to the first week of December. This coincided with an epidemic of scabies in the island. Fifty-five per cent of the patients had scabies with secondary infection. Pyoderma was found in 441 patients (43.7 percent). Sixty-one families had more than one case of acute nephritis. Laboratory investigation included cultures of the skin and throat, grouping and typing of the streptococci, serial estimations of compliment (BIC), Antistreptolysin O titre, BUN and weekly urinalysis. Group A Beta haemolytic streptococci were isolated from 434 patients (73 percent). There were 335 positive cultures from skin sores and 278 from the throat. One hundred and seventy-nine (179) patients had Beta haemolytic streptococci in both skin sores and throat. Of the strains that were M-typed, 245 (60.6 percent) were M-typed 55. T-typing of the streptococci showed that 78.3 percent agglutinated with all the pools (T, U, W, X, Y, and Z). Type 55 streptococcus was first discovered in Trinidad in 1965 and its re-appearance with the 1971 epidemic confirms its nephritogenicity. In marked contrast, there was no increase in the number of cases of acute rheumatic fever, although these patients came from the same socio-economic group and the same areas affected by the epidemic of post-streptococcal acute glomerulonephritis (AU)

Recurrent epidemic nephritis in South Trinidad

An unusually large epidemic of acute glomerulonephritis occurred in Trinidad, the third outbreak on that island in fifteen years. Clinical and laboratory observations on 681 cases in South Trinidad are presented in this report. These data indicated that the majority of cases were poststreptococcal acute glomerulonephritis, associated with impetiginous sores, which are common among children in Trinidad. (AU)

Epidemic acute nephritis in South Trinidad

Two hundred and ninety-seven patients were admitted to the San Fernando General Hospital with acute glomerulonephritis from September 1964 to February 1965. Only a small number of the patients gave a history of sore throat and many patients had septic skin lesions one to four weeks before the onset of oedema, the presenting symptom in all the cases. Children between the ages of 3 and 9 years were most commonly affected. There were 46 children under the age of 3 years. 57 percent of the patients were male. The concentration of cases occurred in the rural areas within a radius of 10 miles from San Fernando, and 76 percent of the patients were Indians. Group A beta Haemolytic streptococci were isolated from the skin and throat of a representative sample of nephritic patients. A pilot streptococcal survey was also conducted among normal school-children in both "nephritic" and "non-nephritic" districts. 66 percent of 50 normal children selected at random from the three schools in Dede (nephritic district) had Group A beta haemolytic streptococci either in the throat or skin. 44 percent of 50 normal school-children from the two school in Tortuga (non-nephritic) had Group A beta haemolytic streptococci. The epidemic is on the wane. The present epidemic was compared with the 1958-1959 epidemic of acute nephritis in South Trinidad (AU)

"Sugar Babies" in Trinidad

The clinical and autopsy features of 20 fatal cases of "Sugar babies" are reported from the Colonial Hospital, San Fernando, Trinidad. At autopsy the most striking finding was the large fatty liver. Treatment of the condition is discussed and the importance of an adequate protein intake during the first year of life is stressed. (AU)