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Cardiac complications in diphtheria and predictors of outcomes

Sunil Samdani1, Avani Jain2, Vinod Meena3

  • 1Department of Otorhinolaryngology (ENT), Sawai Man Singh Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India.

International Journal of Pediatric Otorhinolaryngology
|December 31, 2017
PubMed

Insights

Cardiac complications are common in diphtheria patients, leading to a high mortality rate. Early detection using cardiac biomarkers like troponin T and CK-MB is crucial for predicting outcomes in diphtheria.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Biomarkers

Background:

  • Diphtheria, caused by Corynebacterium diphtheria, can lead to severe cardiac complications.
  • Cardiac involvement in diphtheria is associated with significant morbidity and mortality.

Purpose of the Study:

  • To investigate the prevalence and types of cardiac complications in diphtheria patients.
  • To identify predictors of adverse outcomes, including mortality, in diphtheria patients with cardiac involvement.

Main Methods:

  • A single-center, prospective analysis was conducted.
  • Sixty patients diagnosed with diphtheria and exhibiting electrocardiogram (ECG) changes were included.
  • Cardiac biomarkers including creatine kinase-MB (CK-MB), myoglobin, and cardiac troponin T were assessed.

Main Results:

  • The most frequent ECG changes observed were sinus tachycardia (68.3%), T wave inversion (20%), and ST segment depression (13.3%).
  • The overall case fatality rate was 25%, with 15 patients succumbing to the infection.
  • Elevated levels of CPK-MB, myoglobin, and cardiac troponin T were significantly associated with cardiac mortality. Cardiac troponin T demonstrated the highest sensitivity (80%), while CK-MB showed the highest specificity (95.56%) for predicting mortality.

Conclusions:

  • Cardiac involvement is a frequent and serious complication of diphtheria, contributing to a high mortality rate.
  • Prompt assessment of cardiac biomarkers is essential for risk stratification and management of diphtheria patients.
  • Maximizing diphtheria vaccination coverage, including booster doses, remains critical for preventing this potentially fatal disease.
Abstract

Keywords:
Cardiac troponinDiphtheriaMyocarditisOutcomes

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