Clinical characteristics and management of 676 hospitalized diphtheria cases, Kyrgyz Republic, 1995

The Kyrgyz Republic experienced a widespread resurgence of diphtheria durin g 1994-1998, To describe the clinical characteristics and management of dip htheria patients hospitalized in 1945, a retrospective chart review was con ducted. Physician-diagnosed cases of diphtheria were classified according t o the system recommended by the World Health Organization and UNICEF Among 676 patients hospitalized with respiratory diphtheria, 163 (24%) were carri ers, 186 (28%) had tonsillar forms, 78 (12%) had combined types or delayed diagnosis, and 201 (30%) had severe forms of diphtheria. The highest age-sp ecific incidence rates occurred among persons 15-34 years old, and 70% of c ases were among those greater than or equal to 15 gears of age. Myocarditis occurred among 151 patients (22%), and 19 patients died (case fatality rat io: 3%). Diphtheria antitoxin was administered to 507 patients (75%), and a ll patients received antibiotics (penicillin or erythromycin). Respiratory diphtheria remains a potentially fatal disease, commonly presenting with a typical membranous pharyngitis. Early diagnosis and treatment of cases with diphtheria antitoxin and antibiotics are the cornerstones of effective tre atment.