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Clin Infect Dis. 2008 Feb 1;46(3):395-401. doi: 10.1086/525262.

Investigations of 2 cases of diphtheria-like illness due to toxigenic Corynebacterium ulcerans.

Author information

1
Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. tit2@cdc.gov

Abstract

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.

PMID:
18181738
DOI:
10.1086/525262
[Indexed for MEDLINE]

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