Multidisciplinary approach to the management of a case of classical respiratory diphtheria requiring percutaneous endoscopic gastrostomy feeding.
BMJ Case Rep
; 20172017 Mar 06.
Article
in En
| 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.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Corynebacterium
/
Diphtheria
/
Lung Diseases
/
Anti-Infective Agents
Limits:
Aged
/
Animals
/
Female
/
Humans
Language:
En
Journal:
BMJ Case Rep
Year:
2017
Document type:
Article
Affiliation country:
United kingdom