Laryngeal diphtheria: still a problem

Abstract

Background: Globally diphtheria has been showing a declining trend due to effective childhood vaccination programmes. However, inadequate healthcare delivery systems and other social factors have led to diphtheria re-emerging and remaining endemic in many regions of the world. Securing airway by emergency tracheostomy plays a pivotal role in the management of laryngeal diphtheria in addition to antitoxin.

Methods: This was a retrospective study conducted in Department of ENT, Maulana Azad Medical College from January 2015 to December 2018. The study included cases of diphtheria with stridor or impending airway obstruction. The information collected included age, gender, socioeconomic status and immunization status. The month of presentation was noted to establish the seasonal trend of the infection.  

Results: Maximum number of cases was in the age group of 3 to 9 years (62.3% of total cases). Male children predominated over female children with overall sex ratio of 3:1. Most of the cases presenting to us were partially immunized (51.8%) or unimmunized (44.6%). The maximum number of cases was reported in the month of August to November (96 out of 122 cases). Emergency tracheostomy was done in 86.9% (106 out of 122 cases).

Conclusions: Diphtheria still continues to be a major public health issue in India. Early recognition and treatment are necessary to prevent morbidities and mortalities. Tracheostomy is a speedy and efficient lifesaving procedure in the management of laryngeal diphtheria.