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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]
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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

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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