title: Toxigenic cutaneous diphtheria in a returned traveller.
abstract: Diphtheria is rarely reported in Australia. A case of cutaneous diphtheria was reported to the South Australian Department for Health and Ageing in April 2013 in an Australian-born 18-year-old female following travel in India. The case presented with a skin ulcer on her toe. Toxigenic Corynebacterium diphtheriae was isolated from a swab of the lesion. The case was treated with antibiotics. The public health response included infection control advice, assessing the case and household contacts for organism carriage and providing antimicrobial chemoprophylaxis to contacts. Although cutaneous diphtheria is not included as part of the Australian communicable disease surveillance case definition, this may be an oversight as international evidence demonstrates that it is a source of organism transmission and can potentially result in outbreaks among susceptible populations. This formed the rationale for the public health response to this particular case. The protocol for the public health management of diphtheria in South Australia has since been revised to include cutaneous lesions caused by the toxigenic strain of the organism as part of the surveillance case definition.
authors: Public Health Medicine Registrar, Department of Health, South Australia.
authors: Nur R
authors: NR
authors: Abdul Rahim
authors: Director, Communicable Disease Control Branch, Department of Health, South Australia.
authors: Ann P
authors: AP
authors: Koehler
authors: Medical Consultant, Public Health, Communicable Disease Control Branch, Department of Health, South Australia.
authors: Doug D
authors: DD
authors: Shaw
authors: Public Health Officer, Communicable Disease Control Branch, Department of Health, South Australia.
authors: Caitlin R
authors: CR
authors: Graham
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003353:Corynebacterium diphtheriae / Q000254:growth & development / Q000302:isolation & purification / Q000472:pathogenicity*; D004165:Diphtheria / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D005260:Female; D006801:Humans; D007194:India; D010068:Oxacillin / Q000627:therapeutic use; D012883:Skin Ulcer / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D013021:South Australia; D014034:Toes / Q000382:microbiology / Q000473:pathology; D014195:Travel
chemical_list: D000900:Anti-Bacterial Agents; D010068:Oxacillin