Isolation of Toxigenic Corynebacterium diphtheriae from Chronic Suppurative Otitis Media

Abstract

Background: A major shift in the pathogenic potential of Corynebacterium diphtheriae is being witnessed globally, consequent to the successful diphtheria immunization. However, its isolation from unconventional sites like middle ear has been rarely implicated in the available literature. Case Report: Here we describe a case of chronic suppurative otitis media (CSOM) in a fully immunized young adult patient from whom, Pseudomonas aeruginosa and Klebsiella pneumoniae were isolated as the major pathogens with simultaneous isolation of toxigenic Corynebacterium diphtheriae. The patient had no evidence of Corynebacterium diphtheriae infection on clinical examination, until the organism was incidentally isolated on culture suggesting the possibility of colonization or superimposed infection. Conclusion: Although, the condition was successfully managed with surgical and medical intervention with good outcome, this incidence warrants clinician's attention towards unusual occurrence of a potentially dangerous pathogen. Considering the likelihood of its passive environmental shedding which may pose unseen threat of emergence of fatal diphtheria in the contacts and other susceptible local population, active screening for its carriage is advisable.