Cutaneous infections with Corynebacterium diphtheriae in France: A cohort study - 03/09/25
, Emma d’Anglejan b, Noémie Blumenthal f, Alexander Younes d, Anne-Laure Roux e, Isabelle Bourgault Villada a, Marlène Amara f, Hélène Mascitti a, b, Aurélien Dinh aHighlights |
• | The incidence of diphtheria is likely underestimated due to insufficient awareness. |
• | Although rare, cutaneous diphtheria can serve as a significant reservoir for the disease. It should be considered as a potential diagnosis for any painful, non-healing wound in patients from endemic areas and immunocompromised. |
• | Vaccination against diphtheria, while effective only against toxigenic strains, should be strongly recommended, particularly for migrants living in refugee camps or crowded conditions. |
• | Microbiologists should be aware for this diagnosis due to the common presence of associated co-pathogens, such as Staphylococcus aureus and Streptococcus pyogenes, and it should be specifically sought out. |
Abstract |
Introduction |
Cutaneous diphtheria typically develops on preexisting skin lesions and presents as painful, well-defined ulcers covered by false membranes or as exudate, usually on the limbs.
Patients and methods |
We report on six cases of cutaneous diphtheria recently diagnosed in France. Diagnosis was confirmed through microbiological testing of skin swabs, which identifiedCorynebacterium diphtheriae non-toxigenic strains.
Results |
All patients presented with painful ulcerations with identifiedCorynebacterium diphtheriae non-toxigenic strains. All patients were treated with a 14-day course of amoxicillin or amoxicillin-clavulanate for polymicrobial cases. In our cohort, the immunocompromised patients (2/6) experienced fatal outcomes, while non-immunocompromised individuals (4/6) responded well to antibiotic treatment.
Conclusion |
Physicians should remain vigilant for cutaneous diphtheria in travelers and immunocompromised patients. However, accurate diagnosis can be challenging due to the presence of polymicrobial infections and common co-pathogens. Actual incidence of cutaneous diphtheria may be underestimated, underscoring a need for heightened awareness and vigilance. Vaccination programs should be implemented, notwithstanding their ineffectiveness on non-toxigenic strains.
Le texte complet de cet article est disponible en PDF.Keywords : Diphtheria, Corynebacterium diphtheriae, Cutaneous diphteria, Emergence, Painful cutaneous ulcers
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Vol 55 - N° 6
Article 105109- septembre 2025 Retour au numéro
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