Prospective study of patients with membranous patch over the tonsil at GIMS, Kalaburagi
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20205057Keywords:
Membranous patch, Diphtheria, PseudomembraneAbstract
Background: Current study was done to know various clinical aspects of membranous patch over the tonsil.
Methods: Data for the study were collected from patients who presented with membranous patch over the tonsil in the department of ENT at GIMS, Kalaburagi from January 2019 to December 2019. This is a prospective case study. 225 patients were included in the study. Once patient was presented to us detailed history, examination and necessary investigations were done.
Results: The present study included 225 patients out of which out of which females were 132 (59%) and males were 93 (41%). The predominant clinical features were sore throat (225 cases), fever (212 cases), dysphagia (90 cases) and bull neck (45 cases). The most common cause of membranous patch over tonsil was found to be diphtheria (68%) followed by streptococcal tonsillitis (30%) and others (2%). In our study microbiological investigations like Albert stain was positive in 153 cases and culture was positive in 140 cases.
Conclusions: It was observed in our study that diphtheria constitutes the majority (68%) and the incidence of adult is almost on par with paediatric age group. Despite of UIP we have seen increased incidence in the adult age group. Hence it requires the health agencies and the Government to increase immunization coverage, as India has witnessed the highest number of cases in the world for the year 2015. As evident from the shift in age groups being infected, adult booster dose has to be introduced at 10 years interval.
References
Sridhar RD, Shoban BA, Rathod JBS, Sravan KC, Rajesh S. Study of Ulcero-membranous lesions of tonsil in an Indian scenario. Indian J Otolaryngol Head Neck Surg. 2017;69(1):16-9.
Meera M, Rajarao M. Diphtheria in Andhra Pradesh-a clinical-epidemiological study. Int J Infect Dis. 2014;19:74-8.
Singhal T, Lodha R, Kapil A, Jain Y, Kabra SK. Diphtheria-down but not out. Indian Pediatr. 2005; 37:728-38.
Ray SK, Das GS, Saha I. A report of diphtheria surveillance from a rural medical college hospital. J Indian Med Assoc. 1998;96(8):236-8.
Bitragunta S, Murhekar MV, Hutin YJ, Penumur PP, Gupte MD. Persistence of diphtheria, Hyderabad, India, 2003–2006. Emerg Infect Dis. 2008;14(7):1144-6.
Havaldar PV. Diphtheria in the eighties: experience in a south Indian district hospital. J Indian Med Assoc. 1992;90(6):155-6.
Immunization surveillance, assessment and monitoring: data, statistics and graphics by subject. Available at: http://www.who.int/immunization_ monitoring/data/ind.pdf. Accessed on 25 June 2020.
Jacob JT. Resurgence of diphtheria in India in the 21st century. Indian J Med Res. 2008;128:669-70.
Karande S. Update on available vaccines in India: report of the APPA VU 2010. Indian J Pediatr. 2011;78(7):845-53.
Phalkey RK, Bhosale RV, Joshi AP, Wakchoure SS, Tambe MP, Awate P, et al. Preventing the preventable through effective surveillance: the case of diphtheria in a rural district of Maharashtra, India. BMC Public Health. 2013;13:317.
Lodha R, Dash NR, Kapil A, Kabra S. Diphtheria in urban slums in north India. Lancet. 2000;355 (9199):204.
Patil N, Gawade N, Gaidhane A, Syed ZQ. Investigating diphtheria outbreak: a qualitative study in rural area. Int J Med Sci Public Health. 2014;3(4):513-6.
National health profile (NHP) of India-2015. Available at http://cbhidghs.nic.in/index2.asp?slid= 1311&sublinkid=1167. Accessed on 25 June 2020.
Murthy GSN, Bhimeswar R, Kumar MV, Prasad PK. Resurgence of diphtheria: Are we ready to treat?. Int J Phonosurg Laryngol. 2013;3(2):42-5.
Vijayashree MS, Viswanatha B, Sambamurthy BN. Clinical and bacteriological study of acute tonsillitis. IOSR J Dental Med Sci. 2014;13(1):37-43.
Diphtheria reported cases. Available at: http://apps.who.int/immunization_monitoring/ globalsummary/timeseries/tsincidencediphtheria.html. Accessed on 25 June 2020.
Ray SK, Das Gupta S, Saha I. A report of diphtheria surveillance from a rural medical college hospital. J Indian Med Assoc. 1998;96:236-38.
Havaldar PV. Diphtheria in the eighties: experience in a south Indian district hospital. J Indian Med Assoc. 1992;90:155-6.
Dravid MN, Joshi SA. Resurgence of diphtheria in Malegaon and Dhule regions of north Maharashtra. Indian J Med Res. 2008;127:616-7.
Nakajima H, Kariya H, Ohata R, Ogura H. Investigation of immunity level against diphtheria and reinforcement of immunity by booster vaccination for infection control staff in Okayama Prefecture. Jpn J Infect Dis. 2008;61(2):104-6.
National centre for disease control. Available at: http://ncdc.gov.in/writereaddata/linkimages/February_Final_020862513827.pdf. Accessed on 25 June 2020.