13261              DIPHTHERIA

The patient was a girl aged 4 who had been ill for six days with a sore throat and some respiratory distress.  There was a ‘croupy’ cough.  On examination yellow-grey membrane was present over the tonsils and uvula and there was a mucous discharge from the nostrils.  The temperature was 100.4o.  Diphtheria was suspected but throat swabs showed Vincent’s organism only.  There was a lymphocytosis in the peripheral blood.  Penicillin treatment was begun, but the temperature rose to 102.8o and the child died next day in acute respiratory distress.  Swab from the nose at postmortem grew Corynebacterium diphtheriae gravis.

The specimen consists of the tongue, larynx and proximal trachea mounted with slices of the right lung.  Patches of yellow adherent membrane with surrounding congestion are visible on both tonsils.  Membrane with inflammatory reaction extends over the posterior surface of the epiglottis, which is swollen, and through the larynx and trachea.  The main bronchus in the hilum of the lung shows membrane blocking the lumen and extending into the lung.  On the cut surface of the lung there is haemorrhagic consolidation in the hilar aspects of the upper lobe and in the lingula, and in the apical segment of the lower lobe.