Diphtheritic Myocarditis in an Unvaccinated Child
Esmel Vilomara, Roger (Institut de Recerca Sant Pau)
Figueras-Coll, Marc (Hospital Universitari Vall d'Hebron)
Rosés-Noguer, Ferran (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Balcells Ramírez, Joan (Institut de Recerca Sant Pau)
Gran, Ferran (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública

Date:	2025
Abstract:	Diphtheria, a preventable yet potentially fatal childhood disease, remains a significant threat to unimmunized children, despite its decreased prevalence due to widespread vaccination. A 6-year-old unvaccinated Spanish boy presented with diphtheritic myocarditis. His condition rapidly deteriorated, leading to cardiogenic shock and ventricular tachycardia, necessitating the use of venoarterial extracorporeal membrane oxygenation and the international procurement of diphtheritic antitoxin (DAT). Myocarditis stands as the primary cause of mortality in diphtheria. Early DAT administration is crucial, but its effectiveness diminishes once the diphtheria toxin binds to tissues, and global accessibility may be challenging due to limited production. In scenarios of refractory cardiogenic shock, the employment of mechanical circulatory support, specifically with left cavity drainage systems, can be vital. Timely vaccination is crucial in preventing diphtheria-related fatalities. Global access to essential treatments like DAT remains a significant challenge.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Diphtheria ; Diphtheria antitoxin ; Diphtheritic myocarditis ; Extracorporeal membrane oxygenation ; Vaccination
Published in:	JACC Case Reports, Vol. 30 Núm. 6 (January 2025) , ISSN 2666-0849

DOI: 10.1016/j.jaccas.2024.102972
PMID: 40118601

6 p, 1.9 MB

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