Cardiovascular and Neurological Complications in a Patient with Diphtheria: About a Case

Elizabeth Castro; Gabriela Chourio; Larry Pérez; Máximo Quintero

doi:doi:10.11648/j.reports.20210103.12

| Peer-Reviewed

Cardiovascular and Neurological Complications in a Patient with Diphtheria: About a Case

Elizabeth Castro, Gabriela Chourio, Larry Pérez, Máximo Quintero

Published in Reports (Volume 1, Issue 3)

Received: 28 August 2021 Accepted: 17 September 2021 Published: 10 November 2021

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Diphtheria is an infectious disease, caused by Corynebacterium diphtheriae, which produces an exotoxin, which is responsible for the local clinical manifestations and can lead to complications such as renal tabular necrosis, thrombocytopenia, cardiomyopathy and/or neuropathy. We present the case of a 36-year-old male patient, with no known pathological history, admitted with a diagnosis of Suspicious Case of Diphtheria, received Diphtheria Antitoxin, Tetanus Toxoid, Sodium Penicillin for 3 days and then continued with Azithromycin for 11 days. During his in-hospital evolution, the patient presented chest pain in the precordial region, electrocardiographic changes and elevated cardiac biomarkers were evidenced. Later, he was discharged from the institution due to an improvement in the clinical picture, however, 3 weeks later, he presented dysphagia to solids and decreased muscular strength in the lower extremities, bilateral, symmetrical, limiting ambulation, ascending, with subsequent involvement of the upper extremities; The physical examination revealed paralysis of the IX right cranial nerve, global IV/V muscle strength, global hyporeflexia, for which he was admitted with the diagnosis of acute post-infectious diphtheria inflammatory demyelinating polyradiculoneuropathy, later the patient presented torpid and unfavorable evolution that arrived upon death. Despite early diagnosis and timely treatment, diphtheria has a high mortality rate, which warrants efficient epidemiological surveillance and a multidisciplinary team for the management and control of cases.

Published in	Reports (Volume 1, Issue 3)
DOI	10.11648/j.reports.20210103.12
Page(s)	24-27
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Diphtheria, Cardiovascular Complications, Neurological Complications

References

[1]	Parande M., Mantur R., Mantur B., Parande A., & Shinde R. (2017). Resurgence of diphtheria in rural areas of North Karnataka, India, Indian Journal of Medical Microbiology, 35, 247-251.
[2]	Kliegman R., Stanton B., Schor N., St. Geme J., & Behrman R. (2011). Part XVII Infectious Diseases. Diphtheria (Corynebacterium diphtheriae), Nelson Treaty of Pediatrics, 19^th edition, Elsevier, 180, 1-4.
[3]	Guiso N. (2015). Impact of vaccination on epidemiology of diphtheria and pertussis, Molecular Therapy and Prevention of Human Disease (URE), Institut Pasteur, Paris, France. Vaccine Research, 2 (1): 6-8.
[4]	World Health Organization. (2017). Diphtheria vaccine: WHO position paper – August 2017. Weekly epidemiological record Relevé épidémiologique hebdomadaire, 92 (31): 417–436.
[5]	Allam R., Uthappa C., Duerst R., Sorley E., Udaragudi P., Kampa S., & Dworkin M. (2016). A Case–control Study of Diphtheria in the High Incidence City of Hyderabad, India, The Pediatric Infectious Disease Journal, 35, 253-256.
[6]	Both L., Collins S., Zoysa A., White J., Mandal S., & Efstratiou A. (2014). Molecular and epidemiological review of toxigenic diphtheria infections in England between 2007 and 2013. J. Clin. Microbiol., 1-20.
[7]	Sangal V., & Hoskisson Paul. (2016). Evolution, epidemiology and diversity of Corynebacterium diphtheriae: New perspectives on an old foe. Infection, Genetics and Evolution, 43, 354-370.
[8]	Mahomed S., Archary M., Mutevedzi P., Mahabeer Y., Govender P., Ntshoe G., Kuhn W., Thomas J., Olowolagba A., Blumberg L., McCarthy K., Mlisana K., Du Plessis M., Von Gottberg A., & Moodley P. (2017). An isolated outbreak of diphtheria in South Africa, 2015, Epidemiol. Infect., 1-9.
[9]	Garib Z., Danovaro C., Tavarez Y., Leal I., & Pedreira C. (2015). Diphtheria in the Dominican Republic: reduction of cases following a large outbreak. Rev Panam Salud Pública, 38, 292–299.
[10]	Santos L., Sant’Anna L., Ramos J., Ladeira E., Stavracakis R., Borges L., Santos C., Napoleão F., Camello T., Pereira G., Hirata J., Vieira V., Cosme L. Sabbadini P., & Mattos A. (2015). Diphtheria outbreak in Maranhão, Brazil: microbiological, clinical and epidemiological aspects. Epidemiol. Infect., 143, 791–798.
[11]	Lleras, Arelis. (2016). Diphtheria. A current threat. Kasmera. 44 (2): 76.
[12]	Ministry of Popular Power for Health. (2016). Epidemiological week N° 52 from 25 to 31 December 2016. Epidemiological bulletin. Year of edition LX.
[13]	Meera M, & Rajarao M. (2014). Diphtheria in Andhra Pradesh – A clinical-epidemiological study. Int J Infect Dis., 19, 74-78.
[14]	Pan-American Health Organization/World Health Organization. (2018). Epidemiological update: Diphtheria. February 28. Washington, D.C.
[15]	Núñez L., Córdova J., & González J. (2017). Action protocol for epidemiological surveillance and medical conduct in suspected cases of diphtheria. Epidemiology Service of the Autonomous Service University Hospital of Maracaibo, 1–31.

Cite This Article

Plain Text BibTeX RIS

APA Style

Elizabeth Castro, Gabriela Chourio, Larry Pérez, Máximo Quintero. (2021). Cardiovascular and Neurological Complications in a Patient with Diphtheria: About a Case. Reports, 1(3), 24-27. https://doi.org/10.11648/j.reports.20210103.12

Copy | Download

ACS Style

Elizabeth Castro; Gabriela Chourio; Larry Pérez; Máximo Quintero. Cardiovascular and Neurological Complications in a Patient with Diphtheria: About a Case. Reports. 2021, 1(3), 24-27. doi: 10.11648/j.reports.20210103.12

Copy | Download

AMA Style

Elizabeth Castro, Gabriela Chourio, Larry Pérez, Máximo Quintero. Cardiovascular and Neurological Complications in a Patient with Diphtheria: About a Case. Reports. 2021;1(3):24-27. doi: 10.11648/j.reports.20210103.12

Copy | Download

@article{10.11648/j.reports.20210103.12,
  author = {Elizabeth Castro and Gabriela Chourio and Larry Pérez and Máximo Quintero},
  title = {Cardiovascular and Neurological Complications in a Patient with Diphtheria: About a Case},
  journal = {Reports},
  volume = {1},
  number = {3},
  pages = {24-27},
  doi = {10.11648/j.reports.20210103.12},
  url = {https://doi.org/10.11648/j.reports.20210103.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.reports.20210103.12},
  abstract = {Diphtheria is an infectious disease, caused by Corynebacterium diphtheriae, which produces an exotoxin, which is responsible for the local clinical manifestations and can lead to complications such as renal tabular necrosis, thrombocytopenia, cardiomyopathy and/or neuropathy. We present the case of a 36-year-old male patient, with no known pathological history, admitted with a diagnosis of Suspicious Case of Diphtheria, received Diphtheria Antitoxin, Tetanus Toxoid, Sodium Penicillin for 3 days and then continued with Azithromycin for 11 days. During his in-hospital evolution, the patient presented chest pain in the precordial region, electrocardiographic changes and elevated cardiac biomarkers were evidenced. Later, he was discharged from the institution due to an improvement in the clinical picture, however, 3 weeks later, he presented dysphagia to solids and decreased muscular strength in the lower extremities, bilateral, symmetrical, limiting ambulation, ascending, with subsequent involvement of the upper extremities; The physical examination revealed paralysis of the IX right cranial nerve, global IV/V muscle strength, global hyporeflexia, for which he was admitted with the diagnosis of acute post-infectious diphtheria inflammatory demyelinating polyradiculoneuropathy, later the patient presented torpid and unfavorable evolution that arrived upon death. Despite early diagnosis and timely treatment, diphtheria has a high mortality rate, which warrants efficient epidemiological surveillance and a multidisciplinary team for the management and control of cases.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Cardiovascular and Neurological Complications in a Patient with Diphtheria: About a Case
AU  - Elizabeth Castro
AU  - Gabriela Chourio
AU  - Larry Pérez
AU  - Máximo Quintero
Y1  - 2021/11/10
PY  - 2021
N1  - https://doi.org/10.11648/j.reports.20210103.12
DO  - 10.11648/j.reports.20210103.12
T2  - Reports
JF  - Reports
JO  - Reports
SP  - 24
EP  - 27
PB  - Science Publishing Group
SN  - 2994-7146
UR  - https://doi.org/10.11648/j.reports.20210103.12
AB  - Diphtheria is an infectious disease, caused by Corynebacterium diphtheriae, which produces an exotoxin, which is responsible for the local clinical manifestations and can lead to complications such as renal tabular necrosis, thrombocytopenia, cardiomyopathy and/or neuropathy. We present the case of a 36-year-old male patient, with no known pathological history, admitted with a diagnosis of Suspicious Case of Diphtheria, received Diphtheria Antitoxin, Tetanus Toxoid, Sodium Penicillin for 3 days and then continued with Azithromycin for 11 days. During his in-hospital evolution, the patient presented chest pain in the precordial region, electrocardiographic changes and elevated cardiac biomarkers were evidenced. Later, he was discharged from the institution due to an improvement in the clinical picture, however, 3 weeks later, he presented dysphagia to solids and decreased muscular strength in the lower extremities, bilateral, symmetrical, limiting ambulation, ascending, with subsequent involvement of the upper extremities; The physical examination revealed paralysis of the IX right cranial nerve, global IV/V muscle strength, global hyporeflexia, for which he was admitted with the diagnosis of acute post-infectious diphtheria inflammatory demyelinating polyradiculoneuropathy, later the patient presented torpid and unfavorable evolution that arrived upon death. Despite early diagnosis and timely treatment, diphtheria has a high mortality rate, which warrants efficient epidemiological surveillance and a multidisciplinary team for the management and control of cases.
VL  - 1
IS  - 3
ER  -

Copy | Download

Author Information

Elizabeth Castro

Máximo Quintero Faculty of Medicine, University of Zulia, Maracaibo, Venezuela
Gabriela Chourio

Máximo Quintero Faculty of Medicine, University of Zulia, Maracaibo, Venezuela
Larry Pérez

Máximo Quintero Faculty of Medicine, University of Zulia, Maracaibo, Venezuela
Máximo Quintero

Máximo Quintero Faculty of Medicine, University of Zulia, Maracaibo, Venezuela

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Elizabeth Castro, Gabriela Chourio, Larry Pérez, Máximo Quintero. (2021). Cardiovascular and Neurological Complications in a Patient with Diphtheria: About a Case. Reports, 1(3), 24-27. https://doi.org/10.11648/j.reports.20210103.12

Copy | Download

ACS Style

Elizabeth Castro; Gabriela Chourio; Larry Pérez; Máximo Quintero. Cardiovascular and Neurological Complications in a Patient with Diphtheria: About a Case. Reports. 2021, 1(3), 24-27. doi: 10.11648/j.reports.20210103.12

Copy | Download

AMA Style

Elizabeth Castro, Gabriela Chourio, Larry Pérez, Máximo Quintero. Cardiovascular and Neurological Complications in a Patient with Diphtheria: About a Case. Reports. 2021;1(3):24-27. doi: 10.11648/j.reports.20210103.12

Copy | Download

@article{10.11648/j.reports.20210103.12,
  author = {Elizabeth Castro and Gabriela Chourio and Larry Pérez and Máximo Quintero},
  title = {Cardiovascular and Neurological Complications in a Patient with Diphtheria: About a Case},
  journal = {Reports},
  volume = {1},
  number = {3},
  pages = {24-27},
  doi = {10.11648/j.reports.20210103.12},
  url = {https://doi.org/10.11648/j.reports.20210103.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.reports.20210103.12},
  abstract = {Diphtheria is an infectious disease, caused by Corynebacterium diphtheriae, which produces an exotoxin, which is responsible for the local clinical manifestations and can lead to complications such as renal tabular necrosis, thrombocytopenia, cardiomyopathy and/or neuropathy. We present the case of a 36-year-old male patient, with no known pathological history, admitted with a diagnosis of Suspicious Case of Diphtheria, received Diphtheria Antitoxin, Tetanus Toxoid, Sodium Penicillin for 3 days and then continued with Azithromycin for 11 days. During his in-hospital evolution, the patient presented chest pain in the precordial region, electrocardiographic changes and elevated cardiac biomarkers were evidenced. Later, he was discharged from the institution due to an improvement in the clinical picture, however, 3 weeks later, he presented dysphagia to solids and decreased muscular strength in the lower extremities, bilateral, symmetrical, limiting ambulation, ascending, with subsequent involvement of the upper extremities; The physical examination revealed paralysis of the IX right cranial nerve, global IV/V muscle strength, global hyporeflexia, for which he was admitted with the diagnosis of acute post-infectious diphtheria inflammatory demyelinating polyradiculoneuropathy, later the patient presented torpid and unfavorable evolution that arrived upon death. Despite early diagnosis and timely treatment, diphtheria has a high mortality rate, which warrants efficient epidemiological surveillance and a multidisciplinary team for the management and control of cases.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Cardiovascular and Neurological Complications in a Patient with Diphtheria: About a Case
AU  - Elizabeth Castro
AU  - Gabriela Chourio
AU  - Larry Pérez
AU  - Máximo Quintero
Y1  - 2021/11/10
PY  - 2021
N1  - https://doi.org/10.11648/j.reports.20210103.12
DO  - 10.11648/j.reports.20210103.12
T2  - Reports
JF  - Reports
JO  - Reports
SP  - 24
EP  - 27
PB  - Science Publishing Group
SN  - 2994-7146
UR  - https://doi.org/10.11648/j.reports.20210103.12
AB  - Diphtheria is an infectious disease, caused by Corynebacterium diphtheriae, which produces an exotoxin, which is responsible for the local clinical manifestations and can lead to complications such as renal tabular necrosis, thrombocytopenia, cardiomyopathy and/or neuropathy. We present the case of a 36-year-old male patient, with no known pathological history, admitted with a diagnosis of Suspicious Case of Diphtheria, received Diphtheria Antitoxin, Tetanus Toxoid, Sodium Penicillin for 3 days and then continued with Azithromycin for 11 days. During his in-hospital evolution, the patient presented chest pain in the precordial region, electrocardiographic changes and elevated cardiac biomarkers were evidenced. Later, he was discharged from the institution due to an improvement in the clinical picture, however, 3 weeks later, he presented dysphagia to solids and decreased muscular strength in the lower extremities, bilateral, symmetrical, limiting ambulation, ascending, with subsequent involvement of the upper extremities; The physical examination revealed paralysis of the IX right cranial nerve, global IV/V muscle strength, global hyporeflexia, for which he was admitted with the diagnosis of acute post-infectious diphtheria inflammatory demyelinating polyradiculoneuropathy, later the patient presented torpid and unfavorable evolution that arrived upon death. Despite early diagnosis and timely treatment, diphtheria has a high mortality rate, which warrants efficient epidemiological surveillance and a multidisciplinary team for the management and control of cases.
VL  - 1
IS  - 3
ER  -

Copy | Download