Abstract
Diphtheria affected 201 persons in San Antonio, Texas, from 1 December 1969 to 31 December 1970. Three unimmunized children died. The predominant signs and symptoms were sore throat, fever, dysphagia, nausea, and headache. A distinctive edema of the neck was commoner in adults than in children. Infection with beta hemolytic streptococci did not affect the course of diphtheria or the response to treatment. Corynebacterium diphtheriae was sensitive to ampicillin, clindamycin, erythromycin, penicillin, tetracycline, and rifampin. Partial or complete resistance to cephalexin, Colistin, lincomycin, and oxacillin was found. Both penicillin by intramuscular injection and erythromycin by intravenous injection eradicated C. diphtheriae from the pharynx of hospitalized patients. Oral erythromycin treatment compared with a single intramuscular injection of benzathine penicillin showed that benzathine penicillin can be used as an alternate to erythromycin for termination of the carrier state.
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