title: Fatal laryngeal diphtheria in a UK child.
abstract: Over the last century, the infectious causes of acute upper airway obstruction have changed dramatically. Toxigenic Corynebacterium diphtheriae has become rare in the UK due to national immunisation programmes. Since 1986, eight sporadic cases of C diphtheriae were reported, all of whom had recently returned from endemic areas. We describe a case of fatal laryngeal diphtheria in an unimmunised child. Although appropriate antimicrobial cover was provided, antitoxin was not administered due to a low index of suspicion. This case represents the first UK death from C diphtheriae in 14 years and where travel to an endemic country or contact with a known case of diphtheria was not identified. We highlight the need to maintain a high index of suspicion in children for whom completion of the immunisation schedule is not confirmed regardless of travel history. Prompt recognition and timely administration of antitoxin may be life-saving.
authors.affiliation: Paediatric Intensive Care, Evelina Children’s Hospital, Guy’s & St Thomas’ NHS Foundation Trust London, UK.
authors.forename: Anusha
authors.initials: A
authors.lastname: Ganeshalingham
authors.forename: Ian
authors.initials: I
authors.lastname: Murdoch
authors.forename: Bethany
authors.initials: B
authors.lastname: Davies
authors.forename: Esse
authors.initials: E
authors.lastname: Menson
mesh_terms: D002648:Child; D003353:Corynebacterium diphtheriae / Q000302:isolation & purification*; D004165:Diphtheria / Q000382:microbiology*; D017809:Fatal Outcome; D006801:Humans; D007818:Laryngeal Diseases / Q000382:microbiology*; D006113:United Kingdom