1/17. atrioventricular block in a toxic child: do not forget diphtheria.We describe a 4.5-year-old girl who presented with severe febrile throat infection and who, after a few days, developed ventricular tachycardia followed by atrioventricular block. Although a pacemaker was inserted, she died of cardiogenic shock. Throat cultures were positive for corynebacterium diphtheriae.- - - - - - - - - - ranking = 1keywords = throat (Clic here for more details about this article) |
2/17. Retrospective diagnosis of diphtheria by detection of the corynebacterium diphtheriae tox gene in a formaldehyde-fixed throat swab using PCR and sequencing analysis.The tox gene of corynebacterium diphtheriae was detected in a formaldehyde-fixed throat swab taken from a 68-year-old man who was reported to have died of suffocation due to a pharyngeal tumor. dna templates prepared from bacterial cells fixed with 10% formaldehyde were subjected to a PCR analysis with tox gene-specific PCR primers. The resultant 112-nucleotide-long PCR product was sequenced using a dye terminator method, and an expected 57-nucleotide-long internal sequence of the tox gene was detected. This method is applicable for retrospective diagnosis in diphtheria cases in which only a formaldehyde-fixed clinical sample is available.- - - - - - - - - - ranking = 5keywords = throat (Clic here for more details about this article) |
3/17. 'Corynebacterium ulcerans': a potential cause of diphtheria.Symptoms similar to those of diphtheria may occasionally be caused by micro-organisms other than corynebacterium diphtheriae, such as zoonotic corynebacteria. A case of pharyngitis caused by toxigenic 'C. ulcerans' in a 9 year old girl illustrates the importance of including diphtheroids in the differential diagnosis. The presenting symptoms may have been attenuated by previous immunisation against C. diphtheriae. 'C. ulcerans' should be considered in the differential diagnosis of pharyngitis, especially in patients with a history of contact with farm animals or the consumption of raw dairy products.- - - - - - - - - - ranking = 12.277821786727keywords = pharyngitis (Clic here for more details about this article) |
4/17. Respiratory diphtheria in three paediatric patients.From August till November 1998, the Paediatric and Anaesthetic Units of Hospital Kuala Terengganu managed three patients from Kuala Terengganu District who were ventilated for respiratory diphtheria. Their ages were 5, 4 and 7 years old and their immunisation for diphtheria were not complete. All three patients presented with respiratory distress and were ventilated for upper airway obstruction. Their treatment included intravenous penicillin and diphtheria antitoxin. One patient died of cardiogenic shock with secondary pneumonia. Pharyngeal and tonsillar swabs of all three patients grew toxigenic corynebacterium diphtheriae biotype mitis. There were 765 throat cultures taken from contacts. The confirmed positive cultures grew 2 toxigenic and 3 non-toxigenic corynebacterium diphtheriae biotype mitis and surprisingly, 10 non-toxigenic biotype gravis. A prevalence study is needed to document the endemicity of diphtheria in Kuala Terengganu and to determine the carrier rate of both biotypes. Steps have been taken to increase the immunisation coverage in children. The giving of regular booster doses of diphtheria toxoid to the adult population should be considered.- - - - - - - - - - ranking = 1keywords = throat (Clic here for more details about this article) |
5/17. Laryngopharyngitis by Corynebacterium ulcerans.A 71-year-old female patient was hospitalized with membranous laryngopharyngitis typical of classical diphtheria. A toxigenic strain of Corynebacterium ulcerans was isolated from the throat. The patient was treated for 6 days with amoxicillin-clavulanic acid and recovered without complications. This second reported case of diphtheric laryngopharyngitis caused by C. ulcerans in switzerland is a reminder that C. ulcerans should be included as a possible agent in patients with classical diphtheria symptoms.- - - - - - - - - - ranking = 37.833465360181keywords = pharyngitis, throat (Clic here for more details about this article) |
6/17. Cardiac diphtheria in a previously immunized individual.A previously healthy 19-year-old Asian female without significant past medical history presented to the emergency room complaining of a sore throat, difficulty in swallowing, fever, swollen neck, malaise, and myalgia for three to four days. The patient was initially seen at an outside hospital, evaluated by an ear, nose, and throat physician (ENT), and was found to have desquamative pharyngitis. The patient was transferred to our hospital after she continued to experience progressively worsening shortness of breath and went into acute respiratory distress. The patient was found to have laryngeal edema on exam with greenish-black, necrotic-looking tissue extending to the hypopharynx, nasopharynx, and oropharynx. A culture was taken. ENT was consulted for tracheostomy placement. The patient refused to have tracheostomy placed. She went into severe respiratory distress and required urgent tracheostomy. A cardiac consult was obtained. A 2D echocardiogram performed one day after admission revealed an ejection fraction (EF) of 10-20%, normal left ventricular cavity size, normal wall thickness, and severe global systolic dysfunction. There was mild to moderate mitral regurgitation and trace tricuspid regurgitation. The inferior vena cava was dilated and a 1 cm x 1.5 cm questionable mass or thrombus was seen. The patient's throat culture was positive for diphtheria. The CDC was contacted, and the patient was treated with antitoxin with prompt resolution of cardiac symptoms. A repeat echo done five days post-treatment showed improved EF of 65%, normal left ventricular thickness and function, with no clot visualized. She was treated with ceftriaxone and flagyl for ocular motor neuritis, otitis media, and strep. pneumonia with gradual improvement. These were all secondary to the diphtheria toxins, however, the patient continues to be followed as an outpatient by ENT for ongoing problems with swallowing, speech, and trach management.- - - - - - - - - - ranking = 12.575248242377keywords = pharyngitis, sore throat, throat (Clic here for more details about this article) |
7/17. Screening for corynebacterium diphtheriae.A throat swab from a 9 year old girl with pharyngitis yielded a non-toxigenic strain of corynebacterium diphtheriae var mitis and streptococcus group G. C pseudodiphtheriticum was isolated from the throats of two of her four brothers. In each case the isolate was sent to the reference laboratory before full identification. The growth was found to be mixed for one brother; the other isolate being a toxin producing C diphtheriae var gravis. The child was asymptomatic and the case proves that all colonial types on the Hoyles plate should be identified.- - - - - - - - - - ranking = 8.1389108933634keywords = pharyngitis, throat (Clic here for more details about this article) |
8/17. Should we be concerned about diphtheria in the UK?Diphtheria is a very rare condition in the developed world today with the advent of immunisation. Studies from the populations of england and wales, however, suggest a recent increase in the number of notified cases. Sore throat due to a tonsillitis is the most common manifestation and can, thus, present to the clinician. It can also present as, or be complicated by, life-threatening upper airway obstruction. This case demonstrates the former and highlights the latter, in an attempt to raise awareness of a condition which may be seen more frequently in the future.- - - - - - - - - - ranking = 1keywords = throat (Clic here for more details about this article) |
9/17. Diphtheritic polyneuritis in an elderly woman: clinical and neurophysiological follow-up.A 71-year-old English lady initially presented with a bulbar paralysis and, six weeks later, developed a generalised sensori-motor neuropathy. corynebacterium diphtheriae mitis was cultured from her throat swab. Despite a good clinical recovery at one month, nerve conduction velocity was at its lowest. As far as the authors are aware, this is one of the few cases of neurophysiological and clinical follow-up in a British subject with diphtheritic peripheral neuropathy. This case emphasises the importance of giving antitoxin early.- - - - - - - - - - ranking = 1keywords = throat (Clic here for more details about this article) |
10/17. A report of the investigation and control measures instituted after the isolation of toxin-producing corynebacterium diphtheriae mitis from a child in Leeds.This report describes the control measures instituted and further investigations undertaken after the isolation of toxin-producing corynebacterium diphtheriae from a throat swab taken routinely from a nine-year-old boy, recently returned from pakistan, who had been admitted to hospital in Leeds with hepatitis a infection. Four of his siblings were subsequently shown to have identical corynebacterium diphtheriae on throat swabbing, except that in one child the organism did not produce toxin. All the children were asymptomatic carriers.- - - - - - - - - - ranking = 2keywords = throat (Clic here for more details about this article) |
| | Next -> |