CutaneousCorynebacterium Diphtheriae: A Traveller’s Disease?

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Abstract

A Canadian soldier incurred a nonhealing traumatic skin ulcer while on duty in Somalia. The diagnosis of localized cutaneous diphtheria was confirmed by isolation of a toxigenic strain of Corynebacterium diphtheriaefrom the ulcer. The patient was placed in isolation and treated with erythromycin and penicillin for 10 days without antitoxin. He was released when two consecutive daily cultures were negative. Public health officials evaluated his wife, two children and close contacts for carriage, but no carriers or secondary cases were identified. Cutaneous diphtheria as a diagnostic and management patient problem and potential public health problem are discussed.

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Most cited references 5

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The role of cutaneous diphtheria infections in a diphtheria epidemic.

Bart Koopman, Karen Campbell (1975)

Twenty-four people with diptheria and 48 carriers were found in an isolated, circumscribed, rural area during a one-month period. Four patients had cutaneous lesions, which were similar to those of typical impetigo, form which Corynebacterium diptheriae was isolated. These cases constituted an epidemiologic focus from which the other cases were infected. Ten of 52 classroom contacts of two patients with skin infections harbored C. diphtheriae in the pharynx, while only eight of 132 classroom contacts of eight respiratory cases were similarly infected. Respiratory carriage of C. diphtheriae in five of 12 Head start classroom contacts of another patient with cutaneous infection with C. diptheriae in the classroom situation. A tendency toward greater environmental contamination by cutaneous diphtheria than by respiratory diptheria might be related to the greater contagiousness cases.