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Pathology
Concurrent diphtheria and COVID-19 infection in an unvaccinated child
  1. Shivanand Gundalli1,
  2. Sriharish Pujari1,
  3. Aakash Balasubramanian1 and
  4. Sayandeep Das2
  1. 1District Hospital Vijayapura, Vijayapura, KA, India
  2. 2Pathology, Shri B.M. Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Bijapur, Karnataka, India
  1. Correspondence to Dr Sayandeep Das; sayandeepd97{at}gmail.com

Abstract

We report the case of a girl in her middle childhood who presented with progressive neck swelling, sore throat, dysphagia, low-grade fever and malaise, and with no prior vaccinations. Examination revealed a ‘bull neck’ appearance with pseudomembranous pharyngitis, which showed bleeding on membrane removal. The patient did not have any respiratory distress, but RT-PCR confirmed the concurrent coinfection of DPT with SARS-CoV-2. The laboratory investigations exhibited a leucocyte count of 17.2 × 10⁹/L and ALT raised at 113 U/L, indicative of systemic involvement. Imaging showed mild tonsillar calcifications with ground-glass opacities on the chest CT, which placed a CT severity score for cough severity of 13/25, indicating moderate COVID-19 pneumonia. Treatment was intravenous DPT antitoxin (100 000 units) and cefotaxime (1 g two times per day for 14 days). Symptomatic resolution occurred within 10 days, including clearing inflammatory markers and membranes. Recovery was complete and uncomplicated, with no sequelae after 3 months.

  • COVID-19
  • Infections
  • Vaccination/immunisation
  • Mouth

https://doi.org/10.1136/bcr-2024-264530

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    Footnotes

    • X @sayandeepd97

    • Contributors The following authors were responsible for drafting the text, sourcing and editing clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: SG, AB, SP, SD. The following authors gave final approval of the manuscript: SG, AB, SP, SD. Guarantor: SD.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.