TY - JOUR
T1 - A 9-year-old boy with severe diphtherial infection and cardiac complications
AU - Washington, Charles Henry
AU - Issaranggoon Na Ayuthaya, Satja
AU - Makonkawkeyoon, Krit
AU - Oberdorfer, Peninnah
N1 - Publisher Copyright:
Copyright 2014 BMJ Publishing Group. All rights reserved.
PY - 2014/11/20
Y1 - 2014/11/20
N2 - The incidence of diphtheria has decreased since the introduction of an effective vaccine. However, in countries with low vaccination rates it has now become a reemerging disease. Complications from diphtheria commonly include upper airway obstruction and cardiac complications. We present a 9-year-old boy who was diagnosed with diphtheria. He presented with fever, tonsilar plaques, respiratory failure and an incomplete vaccination history. He was endotracheal intubated and received diphtheria antitoxin and penicillin on the first day of hospitalisation. He developed progressive arrhythmias and fulminant myocarditis despite early identi fication and treatment with equine antitoxin and antibiotics. After a temporary transvenous pacemaker insertion due to thirddegree atrioventricular block and hypotension for 1 week, he developed myocardial perforation from the pacemaker tip resulting in pericardial effusion. The treatment included emergency pericardiocentesis and pacemaker removal. His electrocardiogram showed a junctional rhythm with occasional premature ventricular complexes. He then developed ventricular tachycardia and cardiac arrest and finally died.
AB - The incidence of diphtheria has decreased since the introduction of an effective vaccine. However, in countries with low vaccination rates it has now become a reemerging disease. Complications from diphtheria commonly include upper airway obstruction and cardiac complications. We present a 9-year-old boy who was diagnosed with diphtheria. He presented with fever, tonsilar plaques, respiratory failure and an incomplete vaccination history. He was endotracheal intubated and received diphtheria antitoxin and penicillin on the first day of hospitalisation. He developed progressive arrhythmias and fulminant myocarditis despite early identi fication and treatment with equine antitoxin and antibiotics. After a temporary transvenous pacemaker insertion due to thirddegree atrioventricular block and hypotension for 1 week, he developed myocardial perforation from the pacemaker tip resulting in pericardial effusion. The treatment included emergency pericardiocentesis and pacemaker removal. His electrocardiogram showed a junctional rhythm with occasional premature ventricular complexes. He then developed ventricular tachycardia and cardiac arrest and finally died.
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U2 - 10.1136/bcr-2014-206085
DO - 10.1136/bcr-2014-206085
M3 - Article
C2 - 25414216
AN - SCOPUS:84919343890
SN - 1757-790X
VL - 2014
JO - BMJ case reports
JF - BMJ case reports
ER -