Prevention of Acute Glomerulonephritis with Early Treatment of Tonsillitis with Penicillin

Abstract

271 patients with sore throat and clinical signs of acute tonsillitis were studied. Group A streptococci were isolated from 115 patients; 48 of these had potentially nephritogenic types. In 65% of the patients penicillin therapy started within the first 2 days after the first sign of infection; the remaining 35% were treated within 4 days. The clinical term “typical streptococcal tonsillitis” does not seem correct as the same symptoms were present whether streptococci were found or not. A raised erythrocyte sedimentation rate was found in higher frequency among patients with potentially nephritogenic streptococci. A rising antistreptolysin O level was found only among these patients. Mild proteinuria and hematuria were noted 2 weeks after the infection in 11 patients equally distributed among patients with nephritogenic, non-nephritogenic, or with no streptococci. None of the patients developed the clinical picture of acute glomerulonephritis. It is likely that an early penicillin treatment of tonsillitis results in a lowered frequency of acute glomerulonephritis.