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Arch Dis Child doi:10.1136/archdischild-2011-300272
  • Case report

Fatal laryngeal diphtheria in a UK child

  1. Esse Menson3
  1. 1Paediatric Intensive Care, Evelina Children's Hospital, Guy's … St Thomas' NHS Foundation Trust London, UK
  2. 2Directorate of Infection, Guy's & St Thomas' NHS Foundation Trust, London, UK
  3. 3Department of General Paediatrics, Evelina Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
  1. Correspondence to Dr Esse Menson, Department of General Paediatrics, Evelina Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK; esse.menson{at}gstt.nhs.uk
  1. Contributors AG, IM, BD and EM equally contributed to the writing of this case report.

  • Accepted 27 March 2012
  • Published Online First 25 April 2012

Abstract

Over the last century, the infectious causes of acute upper airway obstruction have changed dramatically. Toxigenic Corynebacterium diphtheriae has become rare in the UK due to national immunisation programmes. Since 1986, eight sporadic cases of C diphtheriae were reported, all of whom had recently returned from endemic areas. We describe a case of fatal laryngeal diphtheria in an unimmunised child. Although appropriate antimicrobial cover was provided, antitoxin was not administered due to a low index of suspicion. This case represents the first UK death from C diphtheriae in 14 years and where travel to an endemic country or contact with a known case of diphtheria was not identified. We highlight the need to maintain a high index of suspicion in children for whom completion of the immunisation schedule is not confirmed regardless of travel history. Prompt recognition and timely administration of antitoxin may be life-saving.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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