Vinod Kutty Sharada, Gupta Nitin, Sahu Harsh, Wig Naveet
Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
JNMA J Nepal Med Assoc. 2017 Oct-Dec;56(208):475-7.
A 15-year old male patient presented to us with dyspnoea for four days. He had a history of fever, pseudo-membranous tonsillitis and cervical adenopathy twenty-five days prior to the presentation. On examination and laboratory investigations, he had features suggestive of myocarditis with biventricular failure. There was no reliable history of immunisation and he had a positive history of contact. He was planned for anti-diphtheria toxin but before the anti-toxin could be initiated, the patient succumbed to refractory cardiogenic shock. This was a rare case of late onset diphtheritic myocarditis in an unimmunised adult. With the advent of universal immunisation, there has been a significant decline in the incidence but there is still some road to cover.
一名15岁男性患者因呼吸困难前来就诊，症状已持续四天。他在此次就诊前25天有发热、假膜性扁桃体炎和颈部淋巴结病病史。经检查和实验室检查，他有双心室衰竭提示心肌炎的特征。没有可靠的免疫接种史，但有接触史阳性。计划对其使用抗白喉毒素，但在开始使用抗毒素之前，患者死于难治性心源性休克。这是一例未免疫成年人中罕见的迟发性白喉性心肌炎病例。随着普遍免疫接种的出现，发病率已大幅下降，但仍有一段路要走。
