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Atrioventricular block in a toxic child: do not forget diphtheria

Z Perles1, A Nir, E Cohen

  • 1Department of Pediatrics, Hadassah University Hospital, Jerusalem, Israel.

Pediatric Cardiology
|May 20, 2000
PubMed

Insights

A severe throat infection caused by Corynebacterium diphtheriae led to fatal heart complications in a young child. The case highlights the critical cardiac risks associated with diphtheria, even with medical intervention.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Diphtheria is a serious bacterial infection primarily affecting the respiratory system.
  • Cardiac involvement in diphtheria, though known, can be severe and rapidly progressive.
  • Early recognition and management of complications are crucial for patient outcomes.

Observation:

  • A 4.5-year-old girl presented with severe febrile throat infection.
  • The patient subsequently developed ventricular tachycardia and atrioventricular block.
  • Throat cultures confirmed the presence of Corynebacterium diphtheriae.

Findings:

  • The child experienced rapid cardiac deterioration, progressing to cardiogenic shock.
  • Despite pacemaker insertion, the patient's condition was irreversible.
  • Diphtheria toxin-induced myocarditis is the likely cause of cardiac dysfunction.

Implications:

  • This case underscores the potential for severe, life-threatening cardiac complications from diphtheria in children.
  • It emphasizes the importance of prompt diagnosis and aggressive management of diphtheria and its sequelae.
  • Vaccination remains the most effective preventive strategy against diphtheria and its severe manifestations.

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