ABSTRACT
Background: Diphtheria is a fatal disease and may cause serious complications if not recognized early and treated properly. Objectives:To study the epidemiology, clinical features, complications, and outcomes in respiratory diphtheria. Materials and Methods:Diphtheria cases admitted in the infectious disease hospital, Beliaghata, Kolkata, India between January 2009 to January 2011 were evaluated in respect to demographic profile, immunization status, clinical features, complications, and outcomes. Results: 200 diphtheria cases were studied. 150 (75%) patients had history of an adequate immunization, and 100 (50%) patients were from lower socio-economic groups. Common clinical features observed were throat pain in 148 (74%) cases and fever in 112 (56%) cases. Complications observed were myocarditis in 136 (68%) cases, neuropathy in 30 (15%) cases, and respiratory compromise in 14 (7%) cases. Death occurred in 5 (2.5%) patients. Conclusions:diphtheria is still a public health problem in many developing countries. Strict public health measures like an increased immunization coverage, improvement of socio-economic status, easy availability of anti-diphtheritic serum (ADS), early recognition and effective treatment-all may reduce the incidence and mortality.
Subject(s)
Adult , Aged , Child , Diphtheria/diagnosis , Diphtheria/drug therapy , Diphtheria/epidemiology , Diphtheria/mortality , Diphtheria/therapy , Female , Humans , India , Male , Middle Aged , Tertiary Care Centers , Treatment OutcomeABSTRACT
The Disease Early Warning System in Afghanistan has recently detected a suspected case of Diphtheria in the regional hospital of Herat province on 22 June 2010. The suspected case is a 20 years old, married woman who resides in Herat City. She has been treated with Diphtheria Antitoxin and Antibiotic [Penicillin] and she is currently recovering. No other cases have been detected so far,. The close contacts of this suspected case has been put under observation and have received single prophylactic dose of Benzathin Penicillin. Throat swab has been collected and sent to the Central Public Health Laboratory for laboratory confirmation
Subject(s)
Humans , Adult , Female , Diphtheria/drug therapy , Diphtheria/therapy , Diphtheria ToxoidABSTRACT
In May 1996 there was an outbreak of diphtheria in Buri Ram, Thailand which infected 31 patients, 8 males and 23 females. The mean age of the patients was 8 +/- 5 years. Seventy-four percent had a history of childhood vaccinations. Common signs and symptoms included fever (100%) which was low grade in 61%, sore throat (90%), upper airway obstruction (3%), and hoarseness (10%). Pseudomembranes (seen in 100%) were located on the tonsils (71%), pharynx (22%), larynx (9.6%), and uvula (6%). The mean duration of symptoms prior to admission was 2 days with a range of 1 to 5 days. Complications included upper airway obstruction (10%) and cardiac complications (10%). There were no neurological complication or deaths. There were negative associations between cardiac complications, severity of disease and previous diphtheria vaccination. The ages varied from children to adults. Early recognition and prompt treatment decreased complications and mortality in this group of patients when compared with Chiang Mai and Queen Sirikit National Institute of Child Health (QSNICH) studies.
Subject(s)
Adolescent , Adult , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Diphtheria/drug therapy , Diphtheria Antitoxin/therapeutic use , Diphtheria Toxoid/administration & dosage , Disease Outbreaks , Female , Humans , Incidence , Male , Thailand/epidemiology , Young AdultABSTRACT
Visando avaliar o valor da DL-Carnitina (DLC) como protetor contra a açäo da toxina diftérica sobre o miocárdio, foram estudados prospectivamente 186 pacientes diftéricos internados no Isolamento Infantil do Hospital Oswaldo Cruz, no período de janeiro a dezembro de 85. Os pacientes foram submetidos ao tratamento tradicional (antibióticos e SAD) e divididos aleatoriamente em 2 grupos DLC-90 pacientes que usaram a droga, e grupo controle-96 pacientes que näo a usaram. Os 2 grupos similares quanto a idade, sexo, v acina prévia e tempo início sintomas - ínicio tratamento. No grupo DLC surgiram 9 casos de miocardite, sendo um discutível, motivo pelo qual foi excluído (paciente foi a óbito por provável sepsis e insuficiência repiratória). Dos 8 casos considerados (8,8%) 7 foram de miocardite leve e um de miocardite grave, todos com recuperaçäo total sem seqüelas. No grupo controle surgiram 16 casos de miocardite, dois dos quais discutíveis e que foram excluídos. Dos 14 considerados (14,6%) 6 foram de miocardite leve (todos recuperados sem seqüelas) e 8 de miocardite grave dos quais 7 foram a óbito e um sobreviveu, porém com seqüela importante (fibrose miocárdica com insuficiência cardíaca grau funcional II com medicaçäo). A diferença na incidência de miocrdite nos dois grupos näo foi significante. Entretanto, se considerarmos o número de casos graves e de óbitos, a diferença teve significância estatística (p < 0,05). Os autores concluem que embora reconheçam a necessidade de mais estudos, o uso da DLC na difteria parece conferir proteçäo miocárdica contra a açäo da toxina ciftérica
Subject(s)
Infant , Child, Preschool , Child , Humans , Male , Female , Carnitine/therapeutic use , Diphtheria/drug therapy , Myocarditis/prevention & control , Diphtheria/complications , Myocarditis/etiology , Prospective StudiesABSTRACT
Two hundred and ten cases of diphtheria of both sexes and all ages with seasonal incidence and area prevalences were studied. Therapeutic trial of corticosteroid hormone was done in all cases of diphtheria studied. It was found that cortisone along with conventional drug therapy, the death rate came down to 68%. Age incidence of our cases had similar pattern with current literatures where as we observed some deviation in sex and seasonal incidence.