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Case Reports
. 2023;34(2):117-120.
doi: 10.5830/CVJA-2022-032. Epub 2022 Sep 5.

Diphtheritic myocarditis: a case report, with toxinmediated complications and multi-organ involvement

Kumari Naidoo  1 , Mpumelelo Msimang  2 , Mignon du Plessis  3 , Datshana Prakesh Naidoo  4
Affiliations
Case Reports

Diphtheritic myocarditis: a case report, with toxinmediated complications and multi-organ involvement

Kumari Naidoo et al. Cardiovasc J Afr. 2023.

Abstract

The re-emergence of diphtheria in South Africa in recent years warns of incomplete vaccination coverage. Recent outbreaks have been associated with a high mortality rate, due to late presentation, limited access to antitoxin and the occurrence of serious systemic complications. Death due to diphtheria is most commonly associated with diphtheritic myocarditis, which presents with heart failure, cardiogenic shock and conduction abnormalities. This case highlights the key clinical features and systemic complications, and examines the reasons for the return of diphtheria in our community.

Keywords: diphtheria; heart block; myocarditis.

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Figures

Fig. 1
Fig. 1
Radiographs of the neck show severe laryngeal narrowing.
Fig. 2
Fig. 2
Chest radiograph shows new consolidation/collapse of the right upper lobe, presumed to have resulted from dislodgement of the pseudomembrane, with resultant bronchial obstruction.
Fig. 3
Fig. 3
A. Diphtheritic myocarditis: the cardiac myocytes show myocytolysis (HE × 40). B. Myocardial involvement showing lipid accumulation (HE × 40).
Fig. 4
Fig. 4
A. cute kidney injury (acute tubular necrosis), tubular casts with an inflammatory cell infiltrate (HE × 40). B. Cutaneous ulcer in the foot with superficial exudate. Microbiological and molecular investigations confirmed diphtheria (toxin producing).
See this image and copyright information in PMC

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