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BMJ Case Rep ; 20172017 Mar 06.
Article in English | MEDLINE | ID: mdl-28264806

ABSTRACT

We present a case of a Caucasian woman aged 67 years referred with a 4-day history of sore throat, dysphagia, fever and nasal blockage. Examination revealed a swollen neck and pharyngeal pseudomembrane. A throat swab was positive on culture for Corynebacterium ulcerans, with toxin expression confirmed on PCR and Elek testing. A diagnosis of classical respiratory diphtheria was made, with subsequent confirmation of the patient's domesticated dog as the source of infection. The dog had recently been attacked by a wild badger and was being treated for an ear infection. The patient made a good recovery with intravenous antimicrobial and supportive therapy; however, she subsequently developed a diphtheritic polyneuropathy in the form of a severe bulbar palsy with frank aspiration necessitating percutaneous endoscopic gastrostomy feeding. A mild sensorimotor peripheral neuropathy was also diagnosed. The patient eventually made an almost complete recovery.


Subject(s)
Anti-Infective Agents/therapeutic use , Corynebacterium/isolation & purification , Diphtheria/microbiology , Diphtheria/therapy , Lung Diseases/microbiology , Lung Diseases/therapy , Aged , Animals , Corynebacterium/genetics , Diphtheria/transmission , Disease Management , Dog Diseases/microbiology , Dogs , Enteral Nutrition , Female , Gastrostomy , Humans , Zoonoses/microbiology
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