Document Detail

Investigations of 2 cases of diphtheria-like illness due to toxigenic Corynebacterium ulcerans.
MedLine Citation:
PMID:  18181738     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We present 2 case reports in the United States and investigations of diphtheria-like illness caused by toxigenic Corynebacterium ulcerans. A fatal case occurred in a 75-year-old male Washington resident who was treated with clindamycin but did not receive equine diphtheria antitoxin. A second, nonfatal case occurred in a 66-year-old female Tennessee resident who received erythromycin and diphtheria antitoxin. METHODS: Both case patients and close human and animal contacts were investigated by their respective state health departments. RESULTS: C. ulcerans isolated from the patient who died was resistant to erythromycin and clindamycin. For both isolates, conventional polymerase chain reaction results were positive for A and B subunits of diphtheria toxin gene tox, and modified Elek tests confirmed toxin production. The source of infection remained undetermined for both cases. Neither patient was up-to-date with diphtheria toxoid vaccination. CONCLUSION: These case reports highlight the importance of early treatment with diphtheria antitoxin, the selection of effective antimicrobial agents, and prevention through up-to-date vaccination.
Tejpratap S P Tiwari; Anne Golaz; Diana T Yu; Kristen R Ehresmann; Timothy F Jones; Hal E Hill; Pamela K Cassiday; Lucia C Pawloski; John S Moran; Tanja Popovic; Melinda Wharton
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  46     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-09     Completed Date:  2008-03-06     Revised Date:  2008-09-09    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  395-401     Citation Subset:  IM    
Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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MeSH Terms
Corynebacterium / isolation & purification*
Corynebacterium Infections / drug therapy,  epidemiology*,  microbiology
Diagnosis, Differential
Diphtheria / epidemiology*,  microbiology
Diphtheria Antitoxin / therapeutic use
Diphtheria Toxoid / therapeutic use
Drug Resistance, Multiple, Bacterial
Fatal Outcome
United States / epidemiology
Reg. No./Substance:
0/Diphtheria Antitoxin; 0/Diphtheria Toxoid
Comment In:
Clin Infect Dis. 2008 Jul 15;47(2):288; author reply 289   [PMID:  18564932 ]

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