Raymond Warouw ,Sri Endah Rahayuningsih,Anggraini Alam,Rahmat Budi Kuswiyanto
Department of Pediatrics Faculty of Medicine Universitas Padjadjaran Department of Pediatrics Faculty of Medicine Universitas PadjadjaranHasan Sadikin General Hospital, Bandung Indonesia
Background : Diphtheria is still a health problem in Indonesia. The disease is characterized by focal Corynebacterium diphtheriae growth in the pharynx, the formation of pseudomembrane layer and followed by the systemic spread of the toxin. Diphtheria toxin does not have any specific target organ, however, heart and neurons are commonly affected. Myocarditis is the most frequent complication in the children under ten-year age group whereas neurologic complications are particularly prevalent in adulthood.
Case Presentation Summary : We reported a case of diphtheria tonsilitis associated with complication of myocarditis in an unimmunized girl during the recent 2018 outbreak in West Java Province, Indonesia. The patient was referred to a tertiary center presenting with advanced symptoms of diphtheria with extensive neck swelling, pseudomembranes of the tonsils and pharynx. The patient received an adequate dose of Anti Diphtheria Serum (ADS) after the fifth day of illness, myocarditis complication occurred at the beginning of the second week of the disease course and resulted in mortality.
Learning Points/Discussion : Early ADS administration is the key to the management of diphtheria especially during the outbreak and good vaccination coverage prevents the outbreak.
Keywords: diphtheria myocarditis Anti Diphtheria Serum vaccination
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