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KMID : 0367419660090030025
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Journal of Korean Pediatric Society
1966 Volume.9 No. 3 p.25 ~ p.30
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Clinical Studies on the 88 Cases of Diphtheria
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金熙順/Kim, Hi soon
崔鍾烋/韓永基/Choi, Jong Hue/Han, Young Key
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Abstract
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We observed 88 cases of diphtheria who were admitted to Kyungpook University Hospital during the period of 5 years from 1959 to 1963. The summary of the clinical and laboratory findings including those of electrocardiograms are as follows:
The seasonal peak incidence of the our cases was from November to January and the age incidence was highest in the 4 to 6 years range with the sex ratio of male 1.6: female 1. According to the types of the disease, 56.8% of the patients were laryngeal diphtheria, and it was most prevalent to the age group of 2 to 5 years. 27.3% was pharyngeal type and 13.6% was pharyngoloryngeal type, but there was only one case of nasal type of nasopharyngeal type.
Most of the patients visited and admitted to the hospital 3 to 5 days after the initial complaints.. The presenting complaints at the time of admission were as follows: Anxiety and irritability (86.4%), Hoarseness (80.7%), Dyspnea (77.3%), Elevation of the body temperature (75.0%), Cough (73.9%), and etc. The cervical lymphadenitis was not so popular as we were predicted Pseudomembrane was detected on 43.2% of the cases, and 53.4% of the cases revealed positive results on the smear preparations taken from nasopharynx. On the peripheral blood counts, 85.5% of the patients had mild to moderate degree of anemia, and leukocytosis was detected on the 59.0% of the cases with the range of 10,000 to 25,000/mm3.
On the electrocardiograms obtained at the time of admission, abnormal tracings were detected in 37.5% of cases. Among the major abnormalities, ST segment and T wave changes were noted in 13.9%, right ventricular hypertrophy in 9.1%, left ventricular hypertrophy in 8.3%, and incomplete bundle branch block or prolongation of P-R interval were noted in 5.6% each other.
Profuse amounts of diphtheria antitoxin and antibiotics were used according to the types and severity of the patients. Tracheotomy was performed for 18 cases(20.5%) who had severe cyanosis.
28.4% of the patients showed urinary findings of nephritis. Carditis was found only a case. The other one case had soft palate paralysis and pericarditis with effusion. Bronchitis was rare and noted only a cases of our patients.
3 cases (3.4%) were expired, 2 of those were laryngeal diphtheria and the other one was pharyngeal type with complicating carditis.
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