2015
DOI: 10.1542/peds.2014-3157
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A Case of Necrotizing Epiglottitis Due to NontoxigenicCorynebacterium diphtheriae

Abstract: Diphtheria is a rare cause of infection in highly vaccinated populations and may not be recognized by modern clinicians. Infections by nontoxigenic Corynebacterium diphtheriae are emerging. We report the first case of necrotizing epiglottitis secondary to nontoxigenic C diphtheriae. A fully vaccinated child developed fever, poor oral intake, and sore throat and was found to have necrotizing epiglottitis. Necrotizing epiglottitis predominantly occurs in the immunocompromised host. Laboratory evaluation revealed… Show more

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Cited by 17 publications
(7 citation statements)
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“…Fibrinoid necrosis of the larynx following supraglottitis has been reported in the literature in relation to the immunocompromised population. The most recent case to develop in an immunocompromised patient was caused by a nontoxigenic Corynebacterium diphtheria infection and the paediatric patient was found at presentation to be pancytopenic due to acute lymphoblastic leukaemia [6].…”
Section: Discussionmentioning
confidence: 99%
“…Fibrinoid necrosis of the larynx following supraglottitis has been reported in the literature in relation to the immunocompromised population. The most recent case to develop in an immunocompromised patient was caused by a nontoxigenic Corynebacterium diphtheria infection and the paediatric patient was found at presentation to be pancytopenic due to acute lymphoblastic leukaemia [6].…”
Section: Discussionmentioning
confidence: 99%
“…As evident from few studies, toxin production does not always correlate with the pathogenicity, since non-toxigenic strains are equally seen to be contributing to the harmful effects and severe disease [15,22]. On the other hand, organism carrying the toxin gene may not always express its toxin [23].…”
Section: Discussionmentioning
confidence: 99%
“…C.diphtheriae'nın toksin dışında hastalığa yol açan adezin ve fimbrial proteinler gibi virülans faktörlerinin, toksijenik olmayan C.diphtheriae'ya bağlı enfeksiyonlardan sorumlu olduğu düşünülmüştür 13,14 . Toksin üretimi olmadığında bile C.diphtheriae'nın bakteremi ve menenjit, endokardit, osteomiyelit, septik artrit, hepatit ve periferik embolik hastalık gibi ciddi komplikasyonlara yol açtığı bildirilmiştir 11,[15][16][17][18] .…”
Section: Discussionunclassified
“…Nontoksijenik suşlar ile ciddi solunum sistemi enfeksiyonları çok nadir olmakla birlikte immün sistemi baskılanmış hastalarda ortaya çıkabilir. Literatürde nontoksijenik C.diphtheriae ile ilişkili nekrotizan epiglotit gelişen akut lenfoblastik lösemili 3 yaşında bir çocuk hasta ile afebril pnömoni gelişen 60 yaşında amiyotrofik lateral sklerozlu bir hasta bildirilmiştir 13 . Çalışmamızdaki boğaz sürüntü örneğinde toksijenik olmayan C.diphtheriae saptanan olgular, sadece ÜSYE semptomu olan sağlıklı çocuklardan oluşmaktaydı.…”
Section: Discussionunclassified