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Diphtheritic neuropathy

A Créange1, C Meyrignac, B Roualdes

  • 1Service de Neurologie, Centre Hospitalier Universitaire Henri Mondor, Créteil, France.

Muscle & Nerve
|December 1, 1995
PubMed
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Diphtheria can cause a rare neurological complication, diphtheritic neuropathy, mimicking Guillain-Barré syndrome. This case highlights the importance of considering diphtheria in unvaccinated individuals presenting with demyelinating neuropathy.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Diphtheria, a bacterial infection caused by Corynebacterium diphtheriae, is preventable through vaccination.
  • Neurological complications, though rare, can occur following diphtheria infection.
  • Guillain-Barré syndrome is an autoimmune disorder affecting the peripheral nervous system.

Observation:

  • A 29-year-old unvaccinated Haitian man presented with sore throat, tonsillar exudate, blurred vision, dysphagia, and acute demyelinating neuropathy.
  • Cerebrospinal fluid analysis revealed moderate pleocytosis and elevated protein levels.
  • Serological tests were positive for diphtheria but negative for tetanus, poliomyelitis, HIV, HTLV-1, and Lyme disease.

Findings:

  • The patient's clinical presentation and laboratory findings were consistent with diphtheritic neuropathy.

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  • The neurological symptoms mimicked those typically seen in Guillain-Barré syndrome.
  • The absence of other infectious markers supported diphtheria as the causative agent.

    • Implications:

    • Diphtheritic neuropathy should be included in the differential diagnosis of acute demyelinating neuropathies, particularly in unvaccinated populations.
    • Early recognition and treatment of diphtheria are crucial to prevent severe neurological sequelae.
    • This case underscores the continued public health importance of diphtheria vaccination programs worldwide.