Lessons learned from life‑threatening respiratory and cardiac complications in diphtheria: A case report and literature review
Tan Nicko Octora1,2
, Seruni Estari3,4, Bambang Pujo Semedi1,2, Dominicus Husada3,4
1Department of Anesthesiology and Reanimation, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
2Department of Anesthesiology and Reanimation, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
3Department of Child Health, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
4Department of Child Health, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
Keywords: Cardiac complications, diphtheria, magnesium sulfate, respiratory distress, ventricular tachycardia
Abstract
Diphtheria remains a serious threat and can cause life threatening complications. We report the case of a 6 year old girl with severe respiratory and cardiac involvement due to diphtheria. She presented with classic signs, including pseudomembrane, bull neck, lymphadenopathy, and respiratory distress. Corynebacterium diphtheriae var. mitis with a positive toxigenic strain was confirmed. Her condition worsened, requiring intensive care admission and high flow nasal cannula support. She later developed ventricular tachycardia with hemodynamic instability, which was successfully treated with intravenous magnesium sulfate (MgSO₄). The patient recovered with antibiotics, antitoxin, and supportive care. This case highlights the potential for severe diphtheria complications, even with timely treatment. It also suggests a possible role for MgSO₄ in managing diphtheria induced arrhythmias, though further research is needed. Early diagnosis, aggressive management, and continued vaccination efforts are critical to reducing diphtheria related morbidity and mortality.
How to cite this article: Octora TN, Estari S, Semedi BP, Husada D. Lessons learned from life‑threatening respiratory and cardiac complications in diphtheria: Acase report and literature review. Turk J Emerg Med 2026;26:146-9.
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TNO: Conceptualization (equal), Writing – original draft (lead), Methodology (equal), Resources (equal), Writing – review and editing (equal). SE: Writing – original draft (supporting), Visualization (lead), Methodology (equal), Resources (equal). BPS: Conceptualization (equal), Formal analysis (equal), Writing – review and editing (equal). DH: Formal analysis (equal), Writing – review and editing (equal). All authors have read and approved the submitted version (and any substantially modified version that involves the authors’ contributions to the study) and have agreed to be personally accountable for their own contributions. The authors also agree to ensure that any questions related to the accuracy or integrity of any part of the work, even those in which they were not personally involved, are appropriately investigated, resolved, and that the resolution is documented in the literature.
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