Atypical Cases of Faucial Diphtheria Presenting Without Membrane in Children

Background: Diphtheria is a vaccine preventable disease with characteristic features of fever, sore throat, pseudo membrane and toxemia. Case Characteristics: Recently we have admitted many diphtheria cases at our hospital among which 3 males of around 10-11 years had faucial diphtheria without pseudo membrane over tonsils, pharynx or nose. Observation/ Intervention: Of these, one had bull neck, tonsillitis, carditis and signs of shock, but no membrane. Common signs and symptoms of all these patients included low grade fever, sore throat and tonsillitis without membrane. All three had a positive throat swab for Albert’s stain suggestive of C. diphtheriae. Outcome: The first patient died very soon and couldn’t receive Anti Diphtheritic Serum (ADS); others were given Crystalline Penicillin and ADS. Message: The need for spreading awareness for Routine Immunization still exists.