1. Diphtheria outbreak in Maranhão, Brazil: microbiological, clinical and epidemiological aspects.
- Author
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Santos LS, Sant'anna LO, Ramos JN, Ladeira EM, Stavracakis-Peixoto R, Borges LL, Santos CS, Napoleão F, Camello TC, Pereira GA, Hirata R, Vieira VV, Cosme LM, Sabbadini PS, and Mattos-Guaraldi AL
- Subjects
- Adolescent, Adult, Brazil epidemiology, Child, Corynebacterium diphtheriae drug effects, Diphtheria drug therapy, Diphtheria microbiology, Diphtheria pathology, Drug Resistance, Bacterial, Electrophoresis, Gel, Pulsed-Field, Female, Humans, Male, Microbial Sensitivity Tests, Young Adult, Diphtheria epidemiology, Disease Outbreaks
- Abstract
We describe microbiological, clinical and epidemiological aspects of a diphtheria outbreak that occurred in Maranhão, Brazil. The majority of the 27 confirmed cases occurred in partially (n = 16) or completely (n = 10) immunized children (n = 26). Clinical signs and characteristic symptoms of diphtheria such as cervical lymphadenopathy and pseudomembrane formation were absent in 48% and 7% of the cases, respectively. Complications such as paralysis of lower limbs were observed. Three cases resulted in death, two of them in completely immunized children. Microbiological analysis identified the isolates as Corynebacterium diphtheriae biovar intermedius with a predominant PFGE type. Most of them were toxigenic and some showed a decrease in penicillin G susceptibility. In conclusion, diphtheria remains endemic in Brazil. Health professionals need to be aware of the possibility of atypical cases of C. diphtheriae infection, including pharyngitis without pseudomembrane formation.
- Published
- 2015
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