A Case of Pseudomembranous Laryngitis Caused by <i>Corynebacterium ulcerans</i> with Severe Systemic Complications

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  • Ohno Takafumi
    Department of Otolaryngology-Head and Neck surgery, Ome Municipal General Hospital Department of Head and Neck surgery, Saitama Cancer Center
  • Sakamoto Megumi
    Department of Otolaryngology-Head and Neck surgery, Ome Municipal General Hospital Ome Otolaryngology Clinic
  • Koyama Yutaro
    Department of Otolaryngology-Head and Neck surgery, Ome Municipal General Hospital Department of Otolaryngology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
  • Hatanaka Akio
    Department of Otolaryngology-Head and Neck surgery, Ome Municipal General Hospital Department of Head and Neck surgery, Ageo Central General Hospital

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Other Title
  • 重篤な合併症を生じた <i>Corynebacterium ulcerans</i> による偽膜性喉頭炎の症例
  • 重篤な合併症を生じたCorynebacterium ulceransによる偽膜性喉頭炎の症例
  • ジュウトク ナ ガッペイショウ オ ショウジタ Corynebacterium ulcerans ニ ヨル ギマクセイ コウトウエン ノ ショウレイ

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Abstract

<p>　In Japan, there has been a steady increase in the number of reported cases of Corynebacterium ulcerans infection ever since the infection was first reported in 2003. We encountered a patient with C. ulcerans infection who showed a severe clinical course. A 72-year-old woman presented to our hospital with the chief complaint of breathlessness, and examination revealed a thick white pseudomembrane covering the larynx. Diphtheria toxin-producing C. ulcerans was isolated from the white pseudomembrane. Although the respiratory symptoms seemed to improve with the antimicrobial therapy, the patient developed sudden cardiac arrest, and then, persistent consciousness disturbance and convulsions after she was resuscitated. These symptoms were considered as being caused by the diphtheria toxin produced by C. ulcerans. The general condition of the patient subsequently stabilized, but the consciousness disturbance persisted. When C. ulcerans infection is suspected based on the history and finding of a pseudomembrane in the throat, it is important to initiate prompt treatment, including with diphtheria antitoxin, and ensure careful follow-up.</p>

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