Cutaneous infections with Corynebacterium diphtheriae in France: A cohort study
Héloise Mazoyer1, Emma d'Anglejan2, Noémie Blumenthal3
1Dermatology Department, A. Paré University Hospital, Boulogne Billancourt, France.
Introduction:
Cutaneous diphtheria typically develops on preexisting skin lesions and presents as painful, well-defined ulcers covered by false membranes or as exudate, usually on the limbs.
Patients And Methods:
We report on six cases of cutaneous diphtheria recently diagnosed in France. Diagnosis was confirmed through microbiological testing of skin swabs, which identifiedCorynebacterium diphtheriae non-toxigenic strains.
Results:
All patients presented with painful ulcerations with identifiedCorynebacterium diphtheriae non-toxigenic strains. All patients were treated with a 14-day course of amoxicillin or amoxicillin-clavulanate for polymicrobial cases. In our cohort, the immunocompromised patients (2/6) experienced fatal outcomes, while non-immunocompromised individuals (4/6) responded well to antibiotic treatment.
Conclusion:
Physicians should remain vigilant for cutaneous diphtheria in travelers and immunocompromised patients. However, accurate diagnosis can be challenging due to the presence of polymicrobial infections and common co-pathogens. Actual incidence of cutaneous diphtheria may be underestimated, underscoring a need for heightened awareness and vigilance. Vaccination programs should be implemented, notwithstanding their ineffectiveness on non-toxigenic strains.
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