Incidence of cutaneous diphtheria in Bangladesh.

ABSTRACT

PIP: The incidence of cutaneous and faucial diphtheria among 327 patients with skin ulcers from Dhaka, Bangladesh, was established, the organisms typed, and the patients' antitoxin levels determined. Corynebacterium diphtheriae was confirmed in 23 (7%). 33% of the positive swabs were taken from the 6-10 year age group. Only 1 positive throat culture was found, in a patient with a negative skin culture. 18 organisms out of 19 typed were gravis strain and 14 of these produced toxin. 91% of the patients with positive skin cultures had serum antitoxin levels above 0.01 IU/ml, compared to 49% of the negative cases (p.001). All wounds harbored from 1-3 other pathogenic organisms, of which staphylococcus, beta hemolytic streptococcus and E. coli were identified. It is likely that skin wounds infected with C. diphtheriae may aid in the spread of faucial diphtheria.