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Published on: May 31, 2017

Diphtheritic myocarditis: clinical and laboratory parameters of prognosis and fatal outcome

P V Havaldar1, M N Sankpal, R P Doddannavar

  • 1Department of Pediatrics, District Hospital, Belgaum, India. pvhavaldar@usa.net

Annals of Tropical Paediatrics
|November 7, 2000
PubMed

Insights

Myocarditis affects 16.5% of diphtheria patients. Membrane extension to multiple sites, high leukocyte counts, and elevated SGOT levels predict mortality in diphtheria patients.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Clinical Pathology

Background:

  • Diphtheria remains a significant public health concern, particularly in regions with suboptimal vaccination rates.
  • Myocarditis is a serious complication of diphtheria, leading to increased morbidity and mortality.
  • Early identification of risk factors for severe outcomes is crucial for timely intervention.

Purpose of the Study:

  • To investigate the incidence of myocarditis in diphtheria patients.
  • To identify clinical and laboratory predictors of mortality in diphtheria.
  • To evaluate the prognostic value of membrane extent, leukocyte count, and SGOT levels.

Main Methods:

  • Retrospective analysis of 97 throat smear-positive diphtheria cases.
  • Comparison of demographic, clinical, and laboratory data between fatal and non-fatal cases.
  • Statistical analysis to determine significant predictors of mortality.

Main Results:

  • Myocarditis developed in 16.5% of treated diphtheria cases.
  • Significant differences between fatal and non-fatal cases included anatomical extent of membrane formation, total leukocyte count, and SGOT levels.
  • Extension of membrane to two or more sites strongly predicted mortality.
  • Leukocyte count > 25,000 cells/mm3 and SGOT > 80 IU/l showed high predictive values for mortality.

Conclusions:

  • Myocarditis is a common complication of diphtheria.
  • Anatomical extent of membrane, leukocyte count, and SGOT levels are valuable prognostic indicators.
  • These factors can aid in risk stratification and management of diphtheria patients.

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