<h3></h3> A 15 year old girl presented with painful, weeping lesions on both lower limbs. She returned from Ethiopia the day before the hospital visit after having stayed for 40 days. There was a history of injury to her right ankle 3 weeks ago and was treated with oral antibiotics. The wound started to heal but subsequently became itchy and started discharging blood stained fluid. A week later similar lesions developed on her left lower limb. She was born in UK and had all her immunisations. Swab from lesions grew <i>group A betahemolytic streptococcus</i> and non-toxigenic <i>Coryne bacterium diphtheriae</i>. She was initially started on Penicillin and Flucloxacillin. Erythromycin was added after the culture results, as <i>C.diphtheriae</i> was penicillin resistant. She made a complete recovery following 7 days of antibiotics. <i>C.diphtheriae</i> is a non-sporulating, non-encapsulated and non-motile gram positive bacillus.<sup>1</sup> The epidemiological significance and mechanism of pathogenicity of nontoxigenic <i>C. diphtheriae</i> is unclear. In Australia, seven cases of endocarditis due to non-toxigenic <i>C. diphtheriae</i> have been reported.<sup>2</sup> Cutaneous diphtheria can be caused by both toxigenic and non-toxigenic strains and the lesions usually appear on exposed parts. The lesions start as vesicles and quickly form small, clearly demarcated ulcers.<sup>3</sup> Symptomatic infections with non-toxigenic <i>C. diphtheria</i> are rare but when identified needs appropriate treatment. There is no need to carry out clearance swabs or to trace contacts of these individ.uals.<sup>4</sup> Skin ulcers not responding to conventional antibiotic treatment should be investigated for rarer causes such as cutaneous diphtheria. <h3>References</h3> Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. New York: Churchill Livingstone, 1995 Tiley SM, Kociuba KR, Heron LG, Munro R. Infective endocarditis due to non-toxigenic Corynebacterium diphtheriae: Report of seven cases and review. Clin Infect Dis 1993;16:271–5 Maegraith B, editor. Clinical tropical diseases. 9th edition. Oxford: Blackwell Scientific Publications, 1989 Bonnet JM, Begg NT. Control of diphtheria: Guidance for consultants in communicable disease control. Commun Dis Public Health 1999;2:242–9