Acute epiglottitis from diphtheria: the forgotten but fatal disease

Abstract

Diphtheria is an infectious disease caused by the gram-positive bacillus Corynebacterium diphtheriae. It is transmitted through direct contact with infectious respiratory secretions or skin lesions and was a significant cause of morbidity and mortality worldwide prior to the introduction of vaccination in the 1930s. We report the case of a 12-year-old boy with no history of vaccination who presented with acute upper airway obstruction secondary to respiratory diphtheria. He required endotracheal intubation and was admitted to the intensive care unit. Despite supportive care, the patient developed cardiogenic shock within 24 hours and ultimately succumbed to the infection. This case underscores the importance of maintaining a high index of suspicion for diphtheria in unimmunized patients presenting with acute airway obstruction, tonsillar exudates, and cervical swelling. It also highlights the critical need for effective interdepartmental communication, early diagnostic testing, and timely access to diphtheria antitoxin to improve outcome of this potentially fatal disease. Effort to promote community awareness on national immunization program is imperative on achieving herd immunity to suppress transmission and reduce morbidity associated with vaccine-preventable disease.