A clinical study of complications of diphtheria (original) (raw)
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Study of Diphtheria and Its Complications: A Retrospective Study from a Tertiary Care Hospital
Pediatric Infectious Disease
Aim and objective: To study clinical presentation and complication in diphtheria in pediatric age-group. Materials and methods: Retrospectively 33 clinical diphtheria cases who got admitted to the isolation unit of Niloufer hospital from August 2019 to July 2020 were taken for this study. The epidemiological details, vaccination status, clinical profile, routine blood investigations along with SGOT, ECG, treatment given, and interventions done with outcome were studied. Results: The common symptoms observed were throat pain seen in 26 cases (79%), fever seen in 25 cases (76%), dysphagia seen in 24 cases (75%), bull neck seen in 18 cases (55%), and palpitations seen in 06 cases (18%). Of the 33 patients, 4 (12%) patients had completed vaccination, 29 (88%) cases were either unimmunized or partially immunized as per their age. The complications observed were cardiac involvement evident through elevated serum transaminase and ECG changes seen in 06 cases (18%), neurological involvement seen in 05 cases (15%), renal failure seen in 04 cases (12%), thrombocytopenia seen in 02 cases (6%), and bleeding seen in 01 case (3%). Tracheostomy due to airway compromise required in six cases. A total number of nine (29%) patients died with complications. Conclusion: Diphtheria incidence is relatively more in the age-group >5 years. The common symptoms are throat pain followed by fever, dysphagia, and bull neck. Common complications observed are myocarditis associated with high mortality, palatal palsy, renal failure, and thrombocytopenia. An increase in vaccination coverage is an effective preventive measure to reduce the incidence of diphtheria.
Clinical Manifestation of Childhood Diphtheria
Jurnal Ilmiah Kedokteran Wijaya Kusuma, 2023
Even though diphtheria vaccination has been routinely done all around the world, some of developing country still reported outbreak. Indonesia declared diphtheria outbreak in 2017. Diphtheria is characterized by sore throat, fever and the formation of pseudo-membrane located in the tonsils, pharynx or nasal cavity. Diphtheria is very common in children. This study was conducted to determine the clinical picture of diphtheria in children at Sulianto Saroso Infectious Disease Hospital January 2018-December 2018. The study was descriptive cross-sectional using medical records of diphtheria patients for the period January 2018-December 2018. The sample is 141 diphtheria patients with the total sampling method. Data analysis using univariate. In this study, out of 141 children with diptheria, the highest number of cases was recorded boy (58,2%), among 6-11 years old, and fully vaccinated (60.3%). Most patient complained about sore throat (95%), fever (93.6%), and bullneck (32.6%). Majority of diphtheria patients with bilateral tonsillar membranes were also found (71.6%), followed by the majority of negative culture results (66.7%), experienced no complications (78.7%), and discharge (99.3%). Clinical characteristic that commonly appeared were sore throat, fever, and bilateral tonsillar membrane. We found it is important to diagnose and treat early to prevent complication and mortality.
Diphtheria is a re-emerging disease with a changing epidemiology. It is thus essential to recognize diphtheria's clinical profile, patterns of morbidity and mortality, and the level of immunization. This study aimed to analyze the clinical-epidemiological profile of patients with diphtheria at the Infectious Disease Hospital, New Delhi, India. The present study was a cross-sectional investigation conducted on 94 patients diagnosed with diphtheria. The data collection tool was a questionnaire that had questions eliciting details such as socio-demographic characteristics, clinical history, examination findings, and vaccination history. The case fatality rate was calculated. Means and proportions were also measured, and the significance level was set at P <0.05. The meanSD age of the participants was 94.4 years. Laryngeal involvement was found in 10 (11%) participants. Complete diphtheria vaccination doses were taken by 6 (6.4%) participants. The case fatality rate was 13%, and complications such as neuropathy were found in 21 (22%) cases, cardiac problems in 12 (13%), and respiratory problems in 13 (14%). Longer duration of the illness, delayed presentation, and complications were associated with poor clinical outcomes (P<0.05). The majority of diphtheria cases were 6-10 years old and had a low socioeconomic status. Most of them had a partial vaccination against diphtheria. Around one-third of the patients had complications related to diphtheria, and the case fatality rate was also high. Key preventive measures for controlling the deadly diphtheria disease include specialized immunization programs for areas with poor immunization coverage, as well as the early detection and treatment of suspected cases.
Epidemiological investigation of a case of diphtheria
Indian Journal of Medical Specialities, 2010
A five year old female child presented with fever, throat pain and swelling in neck region and was clinically diagnosed as a case of diphtheria and confirmed microbiologically. An epidemiological investigation was conducted, which revealed that the child had received no vaccine against diphtheria. She was managed with antibiotics, anti-diphtheritic anti-sera, DPT and other necessary vaccines as required under UIP. Five other children from the same school were also identified to be sufferring from similar complaints during the same period. All the children were tracked and rapid search for any other similar cases was conducted. History of partial/incomplete immunisation among the close contacts was also obtained and their chemoprophylaxis with oral erythromycin was ensured through government functionaries. No other case of diphtheria has since been reported from this area. This report highlights the steps that need to be adopted for prompt epidemiological investigation of infectious diseases in collaboration with public health authorities to achieve the optimum desired results.
International Congress Series, 2003
This study analysed the number of patients admitted with diphtheria to a teaching hospital in the state of Assam in India over a period of ve years and compared the disease characteristics and management with outcomes and incidences of diphtheria reported in the literature. It was a retrospective analysis of data elicited from clinical records of patients admitted to hospital. A total of 101 admissions were recorded during a ve-year period between March 1997 to March 2002, mostly with pharyngeal diphtheria (90 per cent). The majority of patients had no history of immunization (70 per cent). Signi cant presenting features were a tonsillar patch, sore throat, respiratory distress and fever. All patients were treated with anti-diphtheritic serum and intravenous antibiotics. Steroids were given to 81 per cent of patients and tracheostomy was carried out in 10 per cent of cases. The mortality was 16 per cent. Diphtheria of the respiratory tract remains a potentially fatal disease commonly presenting with membranous pharyngitis. Early diagnosis and treatment with anti-diphtheritic serum and antibiotics remain the cornerstone of treatment. Inadequate immunization cover is deemed responsible for the continued menace of diphtheria.
Clinico-epidemiological Profile of Children with Diphtheria in Tertiary Care Hospital of Nepal
Journal of Nepal Paediatric Society
Introduction: This study was conducted with the aim to describe the clinical presentation of diphtheria in children, relationship between clinical disease and immunization status, complications of the disease and adverse events due to anti diphtheria serum (ADS). Methods: All patients admitted at Tribhuvan University Teaching Hospital, Kathmandu from July 2016 to November 2018 with clinical diagnosis of diphtheria were included in this study. Results: There were total 12 children and age ranged from five to 15 years, out of which seven (58%) were males and five (42%) were females. All of them were immunized except one whose immunization status was unknown. All of them had tonsillopharyngeal diphtheria. Four patients (33%) also had nasal and five (42%) patients had additional laryngotracheal diphtheria. Seven patients had bull neck on presentation. Four patients had airway obstruction due to laryngotracheal diphtheria requiring tracheostomy. Throat swab for Corynebacterium Diphtheria...
International Journal Of Community Medicine And Public Health
Background: Diphtheria is a potentially fatal infection caused by Corynebacterium (C.) diphtheriae strains and occasionally by toxigenic C. ulcerans and C. pseudotuberculosis strains. Although effective vaccines are available all over the world, this disease has the potential to re-emerge. As there are few studies regarding clinical profile, complications, and immunization status among adult in Telangana, this study will bridge the gap in information regarding demographic data, clinical features, immunization status, and the presence of complications.Methods: Cross sectional study done for a period of 8 months from March-October 2019 at Sir Ronald Ross Institute of Tropical and Communicable Diseases, Hyderabad. Study was done on 150 diphtheria (clinical and microbiologically) positive cases admitted. The collected data was entered in Microsoft excel and analysed using Epi info v.7.2.6.6.Results: Out of the total study participants 34% belong to 10-14 years age group 99.3% had patch ...
Diphtheria in adult - A case report
Indian J Case Reports, 2020
Diphtheria caused by Corynebacterium diphtheriae is a toxin-mediated upper respiratory tract infection. It spreads by airborne respiratory droplets and commonly affects children. The implementation of a Universal Immunization Program has resulted in a decline in the incidence. In spite of the ongoing immunization program, there is an intermittent re-emergence of diphtheria in developing countries like India. The resurgence of diphtheria in the recent past, with a shift in the age from children to adults, poses a major concern. Hereby, we report a case of isolation of toxigenic C. diphtheriae from an adult patient who suffered from diphtheritic tonsillitis.
Resurgence of diphtheria in rural north Karnataka: Clinical profile and outcome
IP innovative publication pvt. ltd, 2019
Introduction: Although, diphtheria is eliminated in many developed countries by effective immunization, diphtheria still continues to be endemic in India and is the leading cause of morbidity and mortality, especially in rural parts of North Karnataka. The objective of the present study is to recognize the clinical profile, morbidity and mortality pattern of diphtheria and to study their immunization status as a hospital based observational study performed in paediatric intensive care unit. Materials and Methods: This study is a hospital based observational study from April 2018 to August 2018 at a tertiary care referral PICU, S.Nijalingappa Medical College and HSK hospital, Bagalkot, Karnataka. The cases were analysed with respect to demographic details, clinical features, immunization status, complications and mortality. Results: The study consisted of 22 children who presented with features suggestive of diphtheria, 90% were >5years of age with male to female ratio of 1.2:1. Of the 22 children 4 (18.2%) children were completely immunized, and 18(81.8%) were partially immunized/not immunized. All patients presented with fever, membrane in throat and throat pain (100%) followed by bull neck 54.5%, dysphagia 36.36%, epistaxis 9% and Airway obstruction 4.54%. Alberts stain was positive in 18 cases (81.8%) and throat swab culture positive in 16 cases (72.7%). Myocarditis was the commonest complication (63.6%) followed by palatal palsy (13.63%), shock (4.5%) and stroke (4.5%). Case fatality rate was 18.18%. Conclusion: Shifting of occurrence of diphtheria in the age group of >5 years suggest the need to improve and strengthen the immunization program specially the booster doses.
Clinical Characteristics and Management of 676 Hospitalized Diphtheria Cases, Kyrgyz Republic, 1995
The Kyrgyz Republic experienced a widespread resurgence of diphtheria during 1994-1998. To describe the clinical characteristics and management of diphtheria patients hospitalized in 1995, a retrospective chart review was conducted. Physician-diagnosed cases of diphtheria were classified according to the system recommended by the World Health Organization and UNICEF. Among 676 patients hospitalized with respiratory diphtheria, 163 (24%) were carriers, 186 (28%) had tonsillar forms, 78 (12%) had combined types or delayed diagnosis, and 201 (30%) had severe forms of diphtheria. The highest age-specific incidence rates occurred among persons 15-34 years old, and 70% of cases were among those у15 years of age. Myocarditis occurred among 151 patients (22%), and 19 patients died (case fatality ratio: 3%). Diphtheria antitoxin was administered to 507 patients (75%), and all patients received antibiotics (penicillin or erythromycin). Respiratory diphtheria remains a potentially fatal disease, commonly presenting with a typical membranous pharyngitis. Early diagnosis and treatment of cases with diphtheria antitoxin and antibiotics are the cornerstones of effective treatment.