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Respiratory diphtheria in three paediatric patients
The Medical Journal of Malaysia
|October 25, 2000
Summary
Three children with incomplete diphtheria immunization required ventilation for respiratory distress. Investigations revealed toxigenic Corynebacterium diphtheriae, highlighting the need for prevalence studies and increased immunization coverage.
Area of Science:
- Infectious Diseases
- Paediatrics
- Public Health
Background:
- Diphtheria remains a significant public health concern, particularly in regions with incomplete immunization coverage.
- Respiratory diphtheria can lead to severe upper airway obstruction requiring intensive management.
Observation:
- Three pediatric patients (ages 5, 4, 7) presented with respiratory distress due to diphtheria.
- All patients had incomplete diphtheria vaccination histories.
- Treatment involved intravenous penicillin, diphtheria antitoxin, and mechanical ventilation.
Findings:
- Cultures from patients confirmed toxigenic Corynebacterium diphtheriae biotype mitis.
- Contact tracing identified both toxigenic and non-toxigenic Corynebacterium diphtheriae biotype mitis, as well as non-toxigenic biotype gravis.
- One patient succumbed to cardiogenic shock and secondary pneumonia.
Implications:
- The findings underscore the importance of maintaining high childhood immunization rates against diphtheria.
- Further prevalence studies are recommended to assess the endemicity and carrier rates of diphtheria in Kuala Terengganu.
- Consideration should be given to booster immunizations for the adult population to prevent resurgence.