Diphtheria presenting in the accident and emergency department

A case of diphtheria encountered in the accident and emergency department is described. In addition, 38 cases of diphtheria have been analysed, and demonstrate that, although now rare in this country, the disease still exists and its clinical features remain unchanged. It presents almost as often in the accident and emergency department as it does to the general practitioner and remains overwhelmingly a disease of children. Diphtheria is still a notifiable disease. The diagnosis must be made clinically and appropriate action taken before the bacteriological confirmation is received. This prevents unnecessary delay in treatment and makes contact tracing less arduous.