Abstract
Diphtheria is an acute infectious upper respiratory tract disease caused by toxigenic strains of Corynebacterium diphtheria and can lead to significant morbidity and mortality in all the age groups. Most of the time diagnosis of diphtheria is clinical. There may be a dirty white patch covering one or both tonsils on examination for which throat swabs are collected for Kleb’s-Loeffler’s Bacillus (KLB) by direct microscopy and for culture and sensitivity of the organism. To find out the association between clinical diagnosis of diphtheria with smear and culture positivity. 674 cases of Clinical diphtheria were admitted from June 2017 to September 2020 at a tertiary care hospital, Sawai Mansingh Hospital, Jaipur. throat, difficulty in swallowing and swelling in the neck. Out of 674 patients of clinical diphtheria, majority 610 cases (90.5%) were found to have both KLB smear and culture negative. 13 cases (1.9%) were found to have both KLB smear and culture positive. 19 cases (2.8%) were found to have KLB smear positive and culture negative and remaining 32 cases (4.8%) were found to have KLB smear negative and culture positive. Out of 19 patients of KLB smear positive,11 cases (3.5%) were found to have complications. Out of 32 culture positive patients,24 cases (7.7%) were found to have complications. Out of 13 patients of both KLB smear and culture positive,11 cases (3.5%) were found to have complications. Our study concluded that the negative report of KLB smear and culture does not rule out diphtheria and it is evident that percentage of complication is high in patients with either KLB smear or culture or both positive with respect to both being negative. The correlation is found to be significant (p < 0.001).
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Pro-forma of the data taken is filled for every patient and is available with the first author for review.
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No financial funding received. Patients were treated free of cost under ‘MNDY (Mukhyamantri Nishulk Dava Yojana) scheme’ sponsored by Government of Rajasthan.
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“All procedures performed in the presented study involving human participants were in accordance with the ethical standards of the institutional ethical committee of SMS Medical College Jaipur (Letter no. 271/MC/EC/2020) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”
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Jammar, S.K., Kataria, T., Agarwal, S. et al. “An Observational Study on Association of Clinical Diagnosis of Diphtheria with Smear and Culture Test: A Tertiary Care Hospital, Jaipur“. Indian J Otolaryngol Head Neck Surg 74 (Suppl 3), 5375–5380 (2022). https://doi.org/10.1007/s12070-021-02661-2
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DOI: https://doi.org/10.1007/s12070-021-02661-2