[Diagnostic problems in diphtheria infection]

The problem of diagnosis of diphtherial infection has come to acquire especially significance at the present stage because here in Ukraine we have no legitimate standard procedure for identification of a case of diphtheria and because interpretation of results of bacteriological and serological studies in patients who might have diphtheria is often faulty. The diagnosis of atypical cases of mild localized diphtheria in the vaccinated subjects relies on the presence of chronic ENT-affections and a history of predisposition to sore throat. It is necessary that parallel culturing be done of smears obtained from the nasopharynx for diphtheria and pathogen microflora in order that no possibility of angina of other microbe etiology might be entertained. Isolation of nontoxicogenic strains C diphtheria in the absence of clinical signs of diphtheria should not prompt us to diagnose a patients as having this problem. Serologic investigation of the patients serum in the passive hemagglutination test for the presence of antitoxic antibodies can be recommended for use to verify the vaccination history in those having been taken ill rather than to aid in the differential diagnosis of diphtheria and bacteria-carrier states. Results of bacteriological and serological investigations do not give much ground for rejection or confirmation of the diagnosis made.