title: Clinical characteristics and management of 676 hospitalized diphtheria cases, Kyrgyz Republic, 1995.
abstract: The Kyrgyz Republic experienced a widespread resurgence of diphtheria during 1994-1998. To describe the clinical characteristics and management of diphtheria patients hospitalized in 1995, a retrospective chart review was conducted. Physician-diagnosed cases of diphtheria were classified according to the system recommended by the World Health Organization and UNICEF. Among 676 patients hospitalized with respiratory diphtheria, 163 (24%) were carriers, 186 (28%) had tonsillar forms, 78 (12%) had combined types or delayed diagnosis, and 201 (30%) had severe forms of diphtheria. The highest age-specific incidence rates occurred among persons 15-34 years old, and 70% of cases were among those >/=15 years of age. Myocarditis occurred among 151 patients (22%), and 19 patients died (case fatality ratio: 3%). Diphtheria antitoxin was administered to 507 patients (75%), and all patients received antibiotics (penicillin or erythromycin). Respiratory diphtheria remains a potentially fatal disease, commonly presenting with a typical membranous pharyngitis. Early diagnosis and treatment of cases with diphtheria antitoxin and antibiotics are the cornerstones of effective treatment.
authors.affiliation: Department of Childhood Infectious Diseases, Kyrgyz State Medical Institute, Bishkek, Kyrgyz Republic.
authors.forename: R
authors.initials: R
authors.lastname: Kadirova
authors.forename: H U
authors.initials: HU
authors.lastname: Kartoglu
authors.forename: P M
authors.initials: PM
authors.lastname: Strebel
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003353:Corynebacterium diphtheriae / Q000302:isolation & purification*; D004165:Diphtheria / Q000145:classification / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D004168:Diphtheria Toxoid / Q000008:administration & dosage; D019468:Disease Management; D004196:Disease Outbreaks / Q000517:prevention & control; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007707:Kyrgyzstan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D016896:Treatment Outcome; D014611:Vaccination
chemical_list: D000900:Anti-Bacterial Agents; D004168:Diphtheria Toxoid