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[Toxic diphtheria caused by Corynebacterium ulcerans]
M H Hust1, B Metzler, U Schubert
1Medizinische Klinik, Kreiskrankenhauses sowie Praxis für Labormedizin und Mikrobiologie, Reutlingen.
Deutsche Medizinische Wochenschrift (1946)
|April 15, 1994
Summary
A rare case of laryngeal diphtheria caused by Corynebacterium ulcerans in an adult asthmatic patient required prolonged airway support. Prompt antitoxin and antibiotic treatment led to a full recovery without lasting defects.
Area of Science:
- Infectious Diseases
- Pulmonology
- Otolaryngology
Background:
- Diphtheria, typically caused by Corynebacterium diphtheriae, is a serious bacterial infection that can affect the larynx.
- Adult-onset laryngeal diphtheria is uncommon, especially in developed countries with vaccination programs.
- Bronchial asthma can present challenges in managing respiratory distress.
Observation:
- A 42-year-old woman with a history of asthma presented with severe dyspnea and stridor.
- Laryngoscopy revealed a laryngeal membrane significantly narrowing the airway.
- Emergency intubation and later tracheostomy were required for airway management.
Findings:
- Corynebacterium ulcerans, a rare cause of diphtheria, was identified as the causative agent from a laryngeal membrane sample.
- The patient received diphtheria antitoxin and intravenous penicillin G.
- Massive neck swelling and lymphadenopathy complicated the clinical course.
Implications:
- This case highlights the importance of considering diphtheria in adult patients with severe upper airway obstruction, even in vaccinated populations.
- Corynebacterium ulcerans should be recognized as a potential pathogen causing diphtheria-like illness.
- Early diagnosis and aggressive management, including airway support and antimicrobial therapy, are crucial for favorable outcomes in laryngeal diphtheria.