Case series of cutaneous diphtheria in children

Background: Cutaneous diphtheria is caused by infection with Corynebacterium diphtheriae. Transmission from cutaneous lesions can cause both respiratory and cutaneous disease in susceptible contacts.Literature on cutaneous diphtheria report it to be rare post vaccination era due to increased vaccine...

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Main Authors: Dr Aishatu Jibril, Dr Salma Suwaid, Dr Hauwa Makarfi, Prof Hafsah Ahmad
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:International Journal of Infectious Diseases
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Online Access:http://www.sciencedirect.com/science/article/pii/S1201971224005873
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author Dr Aishatu Jibril
Dr Salma Suwaid
Dr Hauwa Makarfi
Prof Hafsah Ahmad
author_facet Dr Aishatu Jibril
Dr Salma Suwaid
Dr Hauwa Makarfi
Prof Hafsah Ahmad
author_sort Dr Aishatu Jibril
collection DOAJ
description Background: Cutaneous diphtheria is caused by infection with Corynebacterium diphtheriae. Transmission from cutaneous lesions can cause both respiratory and cutaneous disease in susceptible contacts.Literature on cutaneous diphtheria report it to be rare post vaccination era due to increased vaccine coverage, but cutaneous diphtheria as an re emerging disease is still common in the tropics and maybe confused with other tropical dermatological disease considering the non- specific pattern of presentation of cutaneous diphtheria.Considering the role of cutaneous diphtheria during outbreaks, a high index of suspicious is required not to miss the diagnosis.It is an important reservoir for ongoing transmission within a susceptible population, and likely to be diagnosed less quickly than respiratory infection because the clinical appearance is nonspecific, and other pathogens often co infect the lesions. Case report: At the beginning of the outbreak, 3 cases of cutaneous diphtheria was reported, all had pseudomembrane with zero with vaccination statusNone had a preexisting skin, only one of the patient survived.Case 1An 8 year old boy who presented with history of cough, fever, inability to swallow, generalised body rash, bleeding from the mouth and nose with abnormal breathing and reduced urine output for 1 week.Had lost 3 siblings to similar illness 2 weeks prior to presentation On examination, he was in severe respiratory distress, generalised bullous skin lesions with areas of desquamation, bull neck, hallitosis, bleeding from the mouth and throat, severely pale. Pulse was small volume and threadyA diagnosis of haemorrhagic diphtheria with cutaneous manifestation in shock. He died within an 1hr of admission.Case 2A 17 year old girl presented with sore throat, fever and cough for 4 days 3 days into admission she complained of vulval swelling and dysuria. Genitourinary examination reveals an edematous vulva with an adherent greyish white membrane. Serology screening and vaginal swabs were both negative, however, histocytology report was highly suggestive of diphtheria. She was discharge after spending 12 days on admission to continue with Sitz bath with diluted hydrogen peroxide.Case 3A case of an infant with both throat and vaginal pseudomembrane, she died from sudden cardiac arrest after 6 days on admission. Discussion: The report highlighted case series of cutaneous diphtheria in children with different presentation of haemorrhagic and ulcer.Cutaneous diphtheria may have played a role in the outbreak as all the patients were from the epicenter of the outbreak. Conclusion: Cutaneous diphtheria should be considered as a differentials of a non healing and painful skin ulcers with greyish membrane especially in a child with poor vaccination history..
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spelling doaj-art-97b24dc975364fe1bc65e122fffa4bc22025-08-20T02:00:41ZengElsevierInternational Journal of Infectious Diseases1201-97122025-03-0115210751210.1016/j.ijid.2024.107512Case series of cutaneous diphtheria in childrenDr Aishatu Jibril0Dr Salma Suwaid1Dr Hauwa Makarfi2Prof Hafsah Ahmad3Federal University Dutse/ Rasheed Shekoni Federal Teaching HospitalMurtala Muhammad Specialist HospitalAhmadu Bello University/ Ahmadu Bello University Teaching Hospital, Zaria, NigeriaAhmadu Bello University/ Ahmadu Bello University Teaching Hospital, Zaria, NigeriaBackground: Cutaneous diphtheria is caused by infection with Corynebacterium diphtheriae. Transmission from cutaneous lesions can cause both respiratory and cutaneous disease in susceptible contacts.Literature on cutaneous diphtheria report it to be rare post vaccination era due to increased vaccine coverage, but cutaneous diphtheria as an re emerging disease is still common in the tropics and maybe confused with other tropical dermatological disease considering the non- specific pattern of presentation of cutaneous diphtheria.Considering the role of cutaneous diphtheria during outbreaks, a high index of suspicious is required not to miss the diagnosis.It is an important reservoir for ongoing transmission within a susceptible population, and likely to be diagnosed less quickly than respiratory infection because the clinical appearance is nonspecific, and other pathogens often co infect the lesions. Case report: At the beginning of the outbreak, 3 cases of cutaneous diphtheria was reported, all had pseudomembrane with zero with vaccination statusNone had a preexisting skin, only one of the patient survived.Case 1An 8 year old boy who presented with history of cough, fever, inability to swallow, generalised body rash, bleeding from the mouth and nose with abnormal breathing and reduced urine output for 1 week.Had lost 3 siblings to similar illness 2 weeks prior to presentation On examination, he was in severe respiratory distress, generalised bullous skin lesions with areas of desquamation, bull neck, hallitosis, bleeding from the mouth and throat, severely pale. Pulse was small volume and threadyA diagnosis of haemorrhagic diphtheria with cutaneous manifestation in shock. He died within an 1hr of admission.Case 2A 17 year old girl presented with sore throat, fever and cough for 4 days 3 days into admission she complained of vulval swelling and dysuria. Genitourinary examination reveals an edematous vulva with an adherent greyish white membrane. Serology screening and vaginal swabs were both negative, however, histocytology report was highly suggestive of diphtheria. She was discharge after spending 12 days on admission to continue with Sitz bath with diluted hydrogen peroxide.Case 3A case of an infant with both throat and vaginal pseudomembrane, she died from sudden cardiac arrest after 6 days on admission. Discussion: The report highlighted case series of cutaneous diphtheria in children with different presentation of haemorrhagic and ulcer.Cutaneous diphtheria may have played a role in the outbreak as all the patients were from the epicenter of the outbreak. Conclusion: Cutaneous diphtheria should be considered as a differentials of a non healing and painful skin ulcers with greyish membrane especially in a child with poor vaccination history..http://www.sciencedirect.com/science/article/pii/S1201971224005873Corynebacterium diphtheriaeCutaneous diphtheriaDiphtheria
spellingShingle Dr Aishatu Jibril
Dr Salma Suwaid
Dr Hauwa Makarfi
Prof Hafsah Ahmad
Case series of cutaneous diphtheria in children
International Journal of Infectious Diseases
Corynebacterium diphtheriae
Cutaneous diphtheria
Diphtheria
title Case series of cutaneous diphtheria in children
title_full Case series of cutaneous diphtheria in children
title_fullStr Case series of cutaneous diphtheria in children
title_full_unstemmed Case series of cutaneous diphtheria in children
title_short Case series of cutaneous diphtheria in children
title_sort case series of cutaneous diphtheria in children
topic Corynebacterium diphtheriae
Cutaneous diphtheria
Diphtheria
url http://www.sciencedirect.com/science/article/pii/S1201971224005873
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