Re-Emerging Diphtheria: Clinical profile and outcome in Children with Diphtheria

Abstract

Introduction / Background: Diphtheria is potentially fatal, vaccine preventable disease. The burden of disease is more in developing countries. The incidence of diphtheria has decreased since the introduction of an effective vaccine in the routine immunization schedule. However, incomplete immunization and failing to receive routine immunization has led to re-emergence of this disease. Aims and objectives: To study the clinical profile, immunization status, morbidity and mortality of patients presented with Diphtheria. Methods: The medical records of children admitted at PICU with Diphtheria from Jan 2018 to Dec 2018were collected from Medical records department. Case details were collected in the proforma after getting approval from the institutional ethical committee. The relevant data collected and outcome were recorded and studied. Results: Among eleven patients of clinically suspected Diphtheria most common age group was 6-11 yrs. No difference in sex distribution, 2 (18.2%) were completely immunized, 1(9.1%) was unimmunized and 8(72.7%) were partially immunized. Majority of patients presented with fever (90.9%), oral patch (63%), bull neck (45.5%) and sore throat (45.5%). Albert stain was positive in 5 (45.5%) patients. ADS was given for 9 (81.8%) patients. Complications developed include Myocarditis 4(36.4%), Airway obstruction 3(27.3%), palatal palsy2 (18.2%), encephalitis 1 (9.15) patient. Four patients (36.4%) improved, 4 left AMA, and 3 (27.3%) children had mortality. Conclusion: There is a resurgence of Diphtheria cases with a high mortality rate which is contributed by incomplete vaccination, which stresses the need for improvement and strengthening of the immunization status of children.

Keywords

• diphtheria
• children