• 1.

    Centers for Disease Control and Prevention. Use of Diphtheria Antitoxin (DAT) for Suspected Diphtheria Cases. Available at: https://www.cdc.gov/diphtheria/downloads/protocol.pdf. Accessed June 21, 2021.

  • 2.

    World Health Organization , 2019. Vaccine-preventable Diseases: Monitoring System. Global summary. Incidence time series for India. Available at: https://apps.who.int/immunization_monitoring/globalsummary/incidences?c=IND. Accessed June 29, 2021.

  • 3.

    Parande MV, Roy S, Mantur BG, Parande AM, Shinde RS , 2017. Resurgence of diphtheria in rural areas of North Karnataka, India. Indian J Med Microbiol 35: 247251.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Gupta A, Gujral M, Singh A, Chawla K , 2020. Diphtheria resurgence in India: a case study from south Karnataka. J Family Med Prim Care 9: 5776.

  • 5.

    Ghosh A, Laxminarayan R , 2017. Demand- and supply-side determinants of diphtheria-pertussis-tetanus non-vaccination and dropout in rural India. Vaccine 35: 10871093.

    • Search Google Scholar
    • Export Citation
  • 6.

    Mohanty A, Bhatia M, Gupta P, Varshney S, Malhotra M, Omar BJ , 2019. Diphtheria: the patch still remains–a case report from the state of Uttarakhand. J Pharm Bioallied Sci 11: 190.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Wiedermann BL , 2020. Diphtheria in the 21st century: new insights and a wake-up call. Clin Infect Dis 71: 9899.

  • 8.

    Roy S , 201i. Indian Council of Medical Research Policy Brief. Diptheria. Available at: https://main.icmr.nic.in/sites/default/files/policy_brief/ICMR_NITM_ROY_Policy_Brief_Diptheria_Final_2017.pdf.

  • 9.

    Kutty JM, RajanBabu B, Thiruvoth S , 2019. Immune status against diphtheria in healthy adults. J Family Med Prim Care 8: 3253.

  • 10.

    Murhekar M , 2017. Epidemiology of diphtheria in India, 1996–2016: implications for prevention and control. Am J Trop Med Hyg 97: 313.

  • 11.

    Raza SA, Nagalotimath U, Achar K , 2011. Diphtheria in an adult: How well prepared are we in tackling the disease? A case report. Indian J Otolaryngol Head Neck Surg 63: 289291.

    • Search Google Scholar
    • Export Citation
  • 12.

    Sangal L et al.2017. Resurgence of diphtheria in North Kerala, India, 2016: laboratory supported case-based surveillance outcomes. Front Public Health 5: 218.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Barroso LF, Pegram PS, Kaplan SL , 2022. Epidemiology and Pathophysiology of Diphtheria. UpToDate. Available at: https://www.uptodate.com/contents/epidemiology-and-pathophysiology-of-diphtheria.

  • 14.

    Maramraj KK, Latha MK, Reddy R, Sodha SV, Kaur S, Dikid T, Reddy S, Jain SK, Singh SK , 2021. Addressing reemergence of diphtheria among adolescents through program integration in India. Emerg Infect Dis 27: 953.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Phalkey RK, Bhosale RV, Joshi AP, Wakchoure SS, Tambe MP, Awate P, Marx M , 2013. Preventing the preventable through effective surveillance: The case of diphtheria in a rural district of Maharashtra, India. BMC Public Health 13: 110.

    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 1021 1021 255
Full Text Views 23 23 18
PDF Downloads 22 22 16




Case Report: Pharyngeal Diphtheria in a Pregnant Woman from South India

View More View Less
  • 1 Cauvery Multispeciality Hospital, Mysore, India;
  • | 2 Department of Microbiology, JSS Medical College, Mysore, India
Restricted access


Diphtheria is a vaccine-preventable disease and is caused by toxigenic strains of Corynebacterium diphtheriae. Several case reports have been published in the recent years, and this resurgence of cases has occurred mainly in adolescent and adult populations. Also, several research articles have reported waning immunity against diphtheria in adults who have completed childhood immunization. Thus, it is an important need to conduct larger sero-surveillance studies to understand the cause of rising diphtheria cases. Here, we report a case of a 23-year-old pregnant women of 8 weeks’ gestation who presented to the outpatient department with fever, severe throat pain, odynophagia, dysphagia, neck pain, and neck swelling of 3 days’ duration. On clinical examination, a gray, leathery membrane was noted on the soft palate. An Albert’s stain from the membrane revealed organisms resembling Corynebacterium diphtheriae. Appropriate treatment was initiated immediately, and follow-up examination at 2 weeks from date of discharge was uneventful. The gray membrane had completely resolved. Contact tracing was done and the appropriate antimicrobial agent was administered. This case study indicates the importance of timely clinical and microbiological diagnosis and reinforces the previously reported resurgence of diphtheria infection.

Author Notes

Address correspondence to R. Deepashree, Department of Microbiology, JSS Medical College, Mysore, 570004, India. E-mail: drdeepu.rajshekar@gmail.com

Authors’ addresses: Suhas S. Pattar, Cauvery Multispeciality Hospital, Mysore, India, E-mail: suhas.pattar@gmail.com; R. Deepashree, M. N. Sumana, S. R. Sujatha, A. Tejashree, Rao Raghavendra, Neetha and Murthy, Department of Microbiology, JSS Medical College, Mysore, India, E-mails: drdeepu.rajshekar@gmail.com, suju7885@gmail.com, drsujathasr@jssuni.edu.in, dr_tejashree@yahoo.co.in, getdrraghurao@yahoo.com, and murthyneetha4@gmail.com.