Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-24T06:56:53.580Z Has data issue: false hasContentIssue false
  • English
  • Français

Diphtheria: a case report

Published online by Cambridge University Press:  23 April 2008

I Khodaei ,
A Sinha  and
A Dingle
I Khodaei*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Leighton Hospital, Crewe, UK
A Sinha
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Leighton Hospital, Crewe, UK
A Dingle
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Leighton Hospital, Crewe, UK
*
Address for correspondence: Mr I Khodaei, 6 Coleridge Dr, Newferry, Wirral CH62 5JT, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

We report a case of diphtheria in an elderly patient, with a fatal outcome.

Method:

Case report and a review of the literature concerning the current recommended guidelines on detection of, and response to, diphtheria.

Results:

Although still rare, cases of diphtheria are being reported with increasing frequency in the UK, possibly as a result of immigration and travel. A high index of suspicion, rapid detection of carriers, and instigation of treatment and vaccination are the mainstays of management.

Conclusion:

Diphtheria can mimic other forms of acute upper airway obstruction and can lead to a fatal outcome. Otorhinolaryngological surgeons need to consider this re-emergent disease as a potential diagnosis in patients with an unusual presentation of airway obstruction.

Keywords

DiphtheriaAirway Obstruction
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 12 , December 2008 , pp. 1397 - 1400
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Amoros-Sebastia, L, Ferrer-Baixaulim, F, Salavert-Fabiani, V, Lopez-Martinez, R. Diphtheria and renaissance Spanish physicians. Acta Otorrhinolaryngol Esp 2002;53:146–50Google ScholarPubMed
2Lindsten, Jan. Nobel Lectures, Physiology or Medicine 1901–1921. Amsterdam, Elsevier, 1967Google Scholar
3Wren, MWD, Shetty, N. Infections with Corynebacterium diphtheria: six years' experience at an inner London teaching hospital. Brit J Biomed Sci 2005;62:1CrossRefGoogle ScholarPubMed
4MacGreggor, RR. Corynebacterium diphtheriae. In: Mandell, G, Bennett, JE, Dolin, R, eds. Principles and Practices of Infectious Diseases. New York: Churchill Livingstone, 1995Google Scholar
5Clarridge, J, Popovic, T, Inzana, T. Diphtheria and other corynebacterial and coryneform infections. In: Collier, L, Balows, A, Sussman, M, eds. Topley and Wilson's Microbiology and Microbial Infections. London: Arnold, 1998:348–52Google Scholar
6Efstratiou, A, George, RC. Microbiology and epidemiology of diphtheria. Rev Med Microbiol 1996;7:31–42CrossRefGoogle Scholar
7Peters, G. Report of the Committee on Infectious Disease (The Red Book). Elk Grove Village, Illinois: American Academy of Paediatrics, 1997;191–5Google Scholar
8Barksdale, L, Garmise, L, Horibata, K. Virulence, toxinogeny, and lysogeny in Corynebaterium Diphtheriae. Ann N Y Acad Sci 1960;88:1095–6CrossRefGoogle Scholar
9Tiley, SM, Kocioba, KR, Heron, LG, Munro, R. Infective endocarditis due to non-toxogenic Corynebacterium diphtheriae: report of seven cases and review. Clin Infect Dis 1993;16:271–5CrossRefGoogle Scholar
10Bonnet, JM, Begg, NT. Control of diphtheria: guidance for consultants in communicable disease control. Commun Dis Pub Health 1999;2:242–9Google ScholarPubMed
11Ditmann, S, Wharton, M, Vitek, C, Ciotti, M, Galazica, A, Guichard, S et al. Successful control of epidemic diphtheria in the states of the former Soviet Socialist Republics: lessons learned. J Infect Dis 2000;181(suppl 1):S10–22CrossRefGoogle Scholar
12Maple, PA, Jones, CS, Wall, EC, Vyseb, A, Edmunds, WJ, Andrews, NJ. Immunity to diphtheria and tetanus in England and Wales. Vaccine 2001;19:167–73CrossRefGoogle Scholar
13Booy, R, Aitken, SJ, Taylor, S, Tudor-Williams, G, Macfarlane, JA, Moxon, ER. Immunogenicity of the combined diphtheria, pertussis, tetanus vaccine given at 2,3,4 months versus 3,5,9 months of age. Lancet 1992;339:507–10CrossRefGoogle Scholar
14Diphteria booster for school leavers. Commun Dis Rep CDR Wkly 1994;4:77Google Scholar
15Anonymous, . DTwP vaccine shortage. Scottish Centre for Infection and Environmental Health Weekly Report 1999;33:313Google Scholar
16Christenson, B, Bottinger, M. Serological immunity to diphtheria in Sweden in 1978 and 1984. Scan J Infect Dis 1986;18:227–33CrossRefGoogle ScholarPubMed
17Karzon, DT, Edwards, KM. Diphtheria outbreaks in immunised populations. N Engl J Med 1988;318:41–3CrossRefGoogle ScholarPubMed
18Velarde Mayol, C, Gomez de Caso, JA, Gil de Miguel, A. Immunity to diphtheria among adults older than 65 years. Med Clin (Barc) 2005;125:409–11Google ScholarPubMed
19Hasselhorn, HM, Nubling, M, Tiller, FW, Hofmann, F. Diphtheria booster immunization for adults [in German]. Dtsch Med Wochenschr 1997;122:281–6CrossRefGoogle ScholarPubMed
20McQuillan, GM, Kruszon-Moran, D, Deforest, A, Chu, SY, Wharton, M. Summaries for patients. Immunity to diphtheria and tetanus in the United States. Ann Intern Med 2002;136:I30CrossRefGoogle Scholar
21Alagappan, K, Rennie, W, Kwiatkownski, T, Narang, V. Antibody protection to diphtheria in geriatric patients: need for ED compliance with immunization guidelines. Ann Emerg Med 1997;30:455–8CrossRefGoogle ScholarPubMed
22Ruben, FL, Nagel, J, Fireman, P. Antitoxin responses in the elderly to tetanus-dipththeria (TD) immunisation. Am J Epidemiol 1978;108:145–9CrossRefGoogle Scholar
23Anonymous, . Toxigenic Corynebacterium diphtheriae acquired in England. Comm Dis Rep 1996;6:27Google Scholar
24Meers, PD. A case of classical diphtheria, and other infections due to Corynebacterium ulcerans. J Infect 1979;1:139–42CrossRefGoogle Scholar
25Hart, RJC. Corynebacterium ulcerans in humans and cattle in North Devon. J Hygiene 1984;92:161–4CrossRefGoogle ScholarPubMed
26Bostock, AD, Gilbert, FR, Lewis, D, Smith, DCM. Corynebacterium ulcerans producing diphtheria toxin. Acta Pathologica Microbiologica et Immunologica Scandinavia 1987;95:361–2Google Scholar
27Mothershed, EA, Cassidy, PK, Pierson, K, Mayer, LW, Popvic, T. Development of a real-time fluorescence PCR assay for rapid detection of diphtheria toxin gene. J Clin Microbiol 2002;40:4713–19CrossRefGoogle ScholarPubMed
28Efstratiou, A, George, RC. Laboratory guidelines for the diagnosis of infections caused by Corynebacterium diphtherias and C. ulcerans. Commun Dis Pub Health 1999;2:250–7Google Scholar