Rarely human infection caused by strains of Corynebacterium capable of producing diphtheria toxin are reported. Affected patients develop clinical findings similar to diphtheria.
Clinical features may include:
(1) low-grade fever
(2) voice change and/or stridor
(3) pharyngeal pseudomembrane formation with airway obstruction
(4) swelling of the neck
(5) septic shock and/or respiratory failure
Laboratory findings:
(1) isolation of Corynebacterium ulcerans from throat culture
(2) demonstration of diphtheria toxin on toxin assay
An affected patient requires:
(1) diphtheria anti-toxin
(2) antibiotic therapy (azithromycin, other)
(3) protection of the airway
People exposed to the patient do not require antibiotic prophylaxis because no human-to-human transmission of C. ulcerans has been documented. The vaccination status to Diphtheria toxin should be determined for each person exposed and a booster dose given when appropriate.
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