Corynebacterium diphtheriaeSkin Infections in Alabama and Louisiana

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Abstract
During a 14-month period, Corynebacterium diphtheriae skin infections were noted in Louisiana and Alabama among 30 of 268 otherwise healthy persons, in six of eight children with clinical diphtheria and in three symptomatic cases of cutaneous diphtheria. In 18 of these an identical strain of C. diphtheriae was simultaneously isolated from the respiratory tract. In households with C. diphtheriae skin infections the overall carrier prevalence was twice that of households with C. diphtheriae respiratory-tract infections. Transmission of C. diphtheriae infections from skin lesion to skin lesion and between respiratory tract and skin lesions was noted. Age was inversely related to the risk of both skin and respiratory-tract C. diphtheriae infection, whereas neither history of artificial immunization nor the diphtheria antitoxin level was related to the risk of such infection.