Cutaneous infections with Corynebacterium diphtheriae in France: A cohort study

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 identified Corynebacterium diphtheriae non-toxigenic strains.

Results

All patients presented with painful ulcerations with identified Corynebacterium 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.