title: Two cases of cutaneous diphtheria associated with occupational pig contact in Germany.
abstract: In 2010, two independent cases of cutaneous diphtheria caused by toxigenic C. ulcerans were identified in Germany. Both patients had intense occupational contact with pigs. Diagnostic work-up comprising biochemical differentiation, rpoB sequencing, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) analysis, real-time tox PCR and Elek test as well as public health measures including an intensified source tracing involving 83 asymptomatic pigs of an associated pig farm are presented.
authors.affiliation: National Consiliary Laboratory for Diphtheria, Oberschleißheim, Germany; Bavarian Health and Food Safety Authority, Oberschleißheim, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Berger
authors.forename: V
authors.initials: V
authors.lastname: Boschert
authors.forename: R
authors.initials: R
authors.lastname: Konrad
authors.forename: T
authors.initials: T
authors.lastname: Schmidt-Wieland
authors.forename: S
authors.initials: S
authors.lastname: Hörmansdorfer
authors.forename: M
authors.initials: M
authors.lastname: Eddicks
authors.forename: A
authors.initials: A
authors.lastname: Sing
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology / Q000662:veterinary; D003352:Corynebacterium / Q000302:isolation & purification*; D004165:Diphtheria / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D004917:Erythromycin / Q000627:therapeutic use; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D015995:Prevalence; D060888:Real-Time Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D012867:Skin / Q000382:microbiology; D017192:Skin Diseases, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D034421:Sus scrofa; D013552:Swine; D013553:Swine Diseases / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004917:Erythromycin
keywords: Corynebacterium ulcerans; Diphtheria; outbreak investigation; zoonosis