Study of Diphtheria and Its Complications: A Retrospective Study from a Tertiary Care Hospital

Abstract

Aim and objective: To study clinical presentation and complication in diphtheria in pediatric age-group. Materials and methods: Retrospectively 33 clinical diphtheria cases who got admitted to the isolation unit of Niloufer hospital from August 2019 to July 2020 were taken for this study. The epidemiological details, vaccination status, clinical profile, routine blood investigations along with SGOT, ECG, treatment given, and interventions done with outcome were studied. Results: The common symptoms observed were throat pain seen in 26 cases (79%), fever seen in 25 cases (76%), dysphagia seen in 24 cases (75%), bull neck seen in 18 cases (55%), and palpitations seen in 06 cases (18%). Of the 33 patients, 4 (12%) patients had completed vaccination, 29 (88%) cases were either unimmunized or partially immunized as per their age. The complications observed were cardiac involvement evident through elevated serum transaminase and ECG changes seen in 06 cases (18%), neurological involvement seen in 05 cases (15%), renal failure seen in 04 cases (12%), thrombocytopenia seen in 02 cases (6%), and bleeding seen in 01 case (3%). Tracheostomy due to airway compromise required in six cases. A total number of nine (29%) patients died with complications. Conclusion: Diphtheria incidence is relatively more in the age-group >5 years. The common symptoms are throat pain followed by fever, dysphagia, and bull neck. Common complications observed are myocarditis associated with high mortality, palatal palsy, renal failure, and thrombocytopenia. An increase in vaccination coverage is an effective preventive measure to reduce the incidence of diphtheria.