Because no respiratory or cutaneous diphtheria cases have been reported for several years in South Africa, we have no baseline genotypic data regarding the underlying population diversity, and hence, we are unable to track transmission patterns or changes in genotypes over time.
Diagnosis 1 8 45903 Respiratory diphtheria 2 8 45236 Respiratory diphtheria 3 ([double dagger]) 9 45237 Respiratory diphtheria 45238 4 31 45262 Cutaneous diphtheria 5 9 45902 Respiratory diphtheria ([section]) 6 5 45463 Respiratory diphtheria ([section]) 7 8 45461 Carrier ([section]) 8 1 45462 Carrier ([section]) 9 41 45464 Respiratory diphtheria 10 17 45465 Respiratory diphtheria 11 13 45466 Respiratory diphtheria 12 21 45785 Respiratory diphtheria 13 6 45786 Carrier ([paragraph]) 14 11 45784 Probable diphtheria 15 11 45789 Carrier (#) 16 9 45790 Carrier (#) 17 11 45791 Carrier (#) 18 10 45792 Carrier (#) 19 13 45787 Respiratory diphtheria ** 20 4 45788 Respiratory diphtheria ** No.
Respiratory diphtheria is nationally notifiable in the United States, but cutaneous diphtheria was not notifiable during 1980-2018; thus, the incidence of cutaneous diphtheria is not well defined (4).
Several common characteristics were observed among the patients with cutaneous diphtheria in this series, which might be useful for future case recognition.
In the absence of signs of toxin dissemination, none of the patients with cutaneous diphtheria received diphtheria antitoxin.
Cutaneous diphtheria has been shown to be more contagious than respiratory diphtheria (8).
diphtheriae is frequent in tropical countries where
cutaneous diphtheria is endemic; cutaneous carriage represents a common mode of transmission of the bacterium.
To our knowledge, these reports are the first of
cutaneous diphtheria in gunshot wounds in recent years.
We report four cases of
cutaneous diphtheria that occurred in the United Kingdom during a 2-month period in 2002 and review past cases.
