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Electrocardiographic abnormalities in patients with diphtheria: a prospective study
Jukka T Lumio1, Kaj W E Groundstroem, Oleg B Melnick
1Department of Medicine, Tampere University Hospital, Tampere, Finland. jukka.lummio@pshp.fi
The American Journal of Medicine
|January 13, 2004
Summary
Cardiac involvement is a common complication of diphtheria in adults. Older age, shared accommodation, fever, and severe respiratory infection are key risk factors for developing electrocardiographic (ECG) abnormalities.
Area of Science:
- Infectious Diseases
- Cardiology
- Public Health
Background:
- Diphtheria, caused by Corynebacterium diphtheriae, can lead to serious cardiac complications.
- Electrocardiographic (ECG) abnormalities are a significant indicator of cardiac involvement.
Purpose of the Study:
- To determine the incidence of ECG abnormalities in adult diphtheria patients.
- To identify risk factors associated with cardiac involvement in diphtheria.
Main Methods:
- Prospective study of 122 adult patients with confirmed respiratory diphtheria.
- Serial clinical evaluations and ECGs performed for at least 21 days.
- Logistic regression analysis to identify independent risk factors.
Main Results:
- Cardiac involvement detected in 28% of 88 evaluable patients.
- Median time to abnormal ECG was 9 days post-symptom onset.
- Independent risk factors included older age, shared accommodation, fever, and extensive infection with edema.
Conclusions:
- Cardiac involvement is a frequent complication of respiratory diphtheria.
- Older patients, those with lower socioeconomic status, and those with severe respiratory symptoms are at higher risk.
- Early identification of risk factors is crucial for managing diphtheria-related cardiac complications.