A Study of Neurological Deficits in Survived Cases of Diphtheria

Abstract

Aims and Objectives: To study the incidence, clinical profile and outcome of children with diphtheritic neuropathy.
 Methodology: A retrospective study of 26 patients with clinical diagnosis of post diphtheritic neuropathy was done. The records were reviewed and information regarding demographic profile, immunization status, clinical presentation, treatment received (medical &/ or surgical including ventilator care) & the outcome were recorded in pro-forma. The results were tabulated and analysed. All the cases who had whitish grey adherent membrane and evidence of neck swelling or has laboratory confirmed evidence (smear or culture positive cases) were diagnosed as cases of diphtheria and amongst them who developed features of neurological deficits like bulbar palsy, cranial nerve involvement or limb weakness were enrolled for further information amongst the survived cases of diphtheria. Patients with other evident cause for neurological deficit were excluded. During this time period total 138 patients of diphtheria were admitted at our hospital and among them 38 patients expired due to various complications. 
 Results: Incidence of Diphtheritic neuropathy was 29.8% among survived cases of diphtheria in our study. Median age of presentation was 7 years and Median latency period was 18 days. Among these patients 96% patients were either partially immunised or unimmunized. All of them had features of bulbar palsy. Isolated palatal palsy was most common presentation and was present in 53.84% patients. GBS like illness was present in 4 (15.38%) patients. Cranial nerve involvement was present in 8% of patients. Full recovery was seen in 30.7% and partial recovery was seen in 46.15% of patients. Boys were more in numbers.
 Conclusion: Diphtheria is a vaccine preventable disease so, routine vaccine administration, prompt diagnosis, early treatment, early administration of ADS and early recognition of complications and treatment of such will reduce associated morbidity and mortality.