Observations on diphtheritic myocarditis DN Guha Mazumder Journal of the Indian Medical Association, Vol 52, No 7,1969,pp. 315-320
Even today, diphtheria remains a widely prevalent disease in West Bengal. Records of the Infectious Disease Hospital, Calcutta, show that the number of diphtheria patients admitted to this hospital was 5287 in 1962, 6214 in 1963, 7173 in 1964, 7034 in 1965 and 5654 in 1966.
Myocarditis is a very frequent complication and also one of the most common causes of death in this disease. It has been said to occur in 10 to 25 per cent of cases(Friedberg, 1956) but careful and frequent clinical and electrocardiographic studies may reveal evidences of myocarditis is as high as 84 percent of severe cases (Begg, 1937; Boyer and Weinstein, 1948).
This paper is based on a study, with particular reference to the myocarditis, based on clinical, electrocardiographic and post mortem examination of a series of 67 bacteriologically proved cases of faucial diphtheria who received standard treatment with antitoxin, antibiotics, etc., under close supervision at the Infectious Disease Hospital, Calcutta.
A Study of Diphtheria Cases Among Hospital Admissions in Calcutta During 1969. DN Guha Mazumder, AK Chakraborty, SK Dutta Journal of the Indian Medical Association, Vol. 55(11),1970,pp. 375-380
Occurrence of diphtheria in and around Calcutta was found to vary from 3 to 7 thousand cases per year during the period of 1963-1968. In 1969, 8366 cases of diphtheria were admitted to Infectious Disease Hospital, Calcutta. The disease was found to occur in all the wards of Calcutta Corporation, but certain wards such as 16, 36 and 56 had proportionately higher incidence. The morbidity and mortality rates in the city of Calcutta were found to vary from 0.29 to 1.34 and 0.02 to 0.06 per thousand respectively. A seasonal variation of the occurrence of the disease was noted with the highest incidence in the months of August and September. Of the 5882 patients studied, 78.29 percent belonged to the age group of 1 to 9 years.
Below 10 years, cases were more in males but females outnumbered the males above this age. Highest number of deaths(60 percent) was observed in children between 1 and 2 years. Morbidity rate amongst exposed population of this age group(1-2 years) was also found to be highest (484.04 per 1000).Usually not more than one person was affected in a family.
Second attack of diphtheria, though rare, was seen in 1.9 percent of cases. 3.1 percent of patients received immunization but the disease was mild in nature in all of them and none died.
SGOT in diphtheritic myocarditis DN Guha Mazumder National Conference on Infectious Disease, Bombay 1968.pp. 151-159.
Sixty seven bacteriologically proved cases of faucial diphtheria of varying severity were investigated clinically and by serial electrocardiography. Autopsy was done in 6 out of 7 fatal cases.Forty two patients had myocarditis. Serial estimations of SGO-T were done in all the 67 cases.31 patients, all showing signs of myocarditis had elevated enzyme levels, the maximum being 533KU/ml, serial estimations in favourable cases showing decreasing values. In 2 cases of myocarditis,ECG did not reveal any abnormality,but definite elevation of the enzyme levels were noticed. In 4 others,though the initial ECGs were normal this become abnormal subsequently, but their SGO-T values were raised from the very beginning.
