Okamoto Koh, Hatakeyama Shuji, Sugita Chise, Ogura Kenichi, Ueda Reiko, Kouda Hiroko, Nakata Junko
Department of Internal Medicine, Tokyo Metropolitan Health and Medical Treatment Corporation Okubo Hospital, Tokyo, Japan; Department of Infectious Diseases, University of Tokyo Hospital, Tokyo, Japan.
Department of Internal Medicine, Tokyo Metropolitan Health and Medical Treatment Corporation Okubo Hospital, Tokyo, Japan; Department of General Internal Medicine/Infectious Diseases, Jichi Medical University Hospital, Tochigi, Japan.
J Infect Chemother. 2018 Sep;24(9):759-762. doi: 10.1016/j.jiac.2018.01.015. Epub 2018 Feb 24.
Toxigenic strains of Corynebacterium diphtheriae cause the majority of respiratory diphtheria cases. However, nontoxigenic strains of C. diphtheriae can also cause diseases, and have become increasingly common. Infection that is limited to the anterior nares (nasal diphtheria) is a well-described but rare condition, even for toxigenic C. diphtheriae. We report a case involving chronic carriage of nasal diphtheria caused by nontoxigenic C. diphtheriae, as well as a review of other reported nontoxigenic C. diphtheriae cases in Japan. Mild or asymptomatic nasal diphtheria involving nontoxigenic strains, which can be the source of transmission, may be underrecognized. Our case highlights the importance of awareness regarding nontoxigenic diphtheria among clinicians, especially in the era of improved diphtheria vaccination coverage.
产毒型白喉棒状杆菌引起了大多数呼吸道白喉病例。然而，非产毒型白喉棒状杆菌也可致病，且已变得越来越常见。局限于前鼻孔的感染（鼻白喉）是一种已被充分描述但罕见的情况，即使对于产毒型白喉棒状杆菌也是如此。我们报告了一例由非产毒型白喉棒状杆菌引起的鼻白喉慢性携带病例，并对日本其他已报告的非产毒型白喉棒状杆菌病例进行了综述。涉及非产毒菌株的轻度或无症状鼻白喉可能未得到充分认识，而这种情况可能是传播源。我们的病例强调了临床医生认识非产毒型白喉的重要性，尤其是在白喉疫苗接种覆盖率提高的时代。
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