The widespread routine immunization of children against diphtheria has resulted in a marked decrease in the incidence of this disease throughout the world. However, in some part of the world, especially in developing countries, diphtheria remains relatively common.
Sixty-seven children with diphtheria, which were seen at the department of pediatrics of Chungnam National University Hospital during the 4 1/2-year period, January, 1974, through June, 1978, were evaluated clinically and the following results were obtained.
1. Annual incidence was highest in 1975 and 1976.
Although the disease was most prevalent in December, November and February, it was observed throughout the season.
2. Thirty-one patients were in the 6 to 10 year age group, 26 in the ´ 11 to 15 year age group, and 10 in the 0 to 5 year age group showing a trend toward greater incidence in the older age group.
3. Pharyngeal type was present in 43 patients occupying 64. 5% of the entire patients, pharyngolaryngeal type in 13, laryngeal type in 6 and nasopharyngeal type in 5.
The pharyngeal type was mostly seen in over 6-year of age and the laryngeal type only in below 10-year of age.
4. The mean duration from onset to admission was 4.3 days.
It was shortest in the laryngeal type and longest in the nasoharyngeal type. The mean positive culture rate of all types was 61.5%.
5. Diphtheria immunizations were performed in 10 patients, the frequency of them being 3 times or less in al!.
6. Common symptoms and signs were pseudomembrane, fever, sore throat E rd bull neck in the order of frequency.
Complications were as follows ; proteinuria and nephritis in 19 patients, myccarditis and respiratory obstruction with tracheotomy each in 11, beta-hemolytic streptccoccal infection in 10, toxic neuritis in 9, preumona in 5, and toxic hepatitis in 2.
7. Mortality rate was about 9,°o and the cause of death was myocarditis in all.
|