Exudative Pharyngitis and Diphtheria
Author Information
Author(s): Paul D. Ellner, H.S. Izurieta, P.M. Strebel, T. Youngblood, D.G. Hollis, T. Popovic
Primary Institution: Columbia University College of Physicians and Surgeons; Centers for Disease Control and Prevention
Hypothesis
Is exudative pharyngitis possibly due to Corynebacterium pseudodiphtheriticum a new challenge in the differential diagnosis of diphtheria?
Conclusion
Prompt administration of diphtheria antitoxin is crucial, especially in cases with a high suspicion of diphtheria.
Supporting Evidence
- Antitoxin treatment cannot wait for laboratory confirmation.
- Delay in initiating antitoxin treatment is associated with increased incidence of myocarditis, paralysis, and death.
- From 1980 to 1995, only 41 cases of respiratory diphtheria were reported in the U.S.
Takeaway
If a child has a sore throat and a gray membrane in their throat, doctors should act quickly to treat it for diphtheria, even if they aren't sure yet.
Methodology
The diagnosis of diphtheria is primarily made presumptively on clinical grounds and confirmed by laboratory recovery of the bacteria.
Limitations
The rarity of respiratory diphtheria in the U.S. complicates diagnosis and treatment decisions.
Participant Demographics
A 4-year-old child.
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