A 12 year old male child presented with toxic symptoms: pyrexia of 105f , on examination significant lymphadenopathy of jugulodigastruc chain , bull neck appearance , ECG shows features of myocarditis, he developed ophthalmoplegia , and neuritis ,DX of diphtheria was done, antitoxin of 100000iu was given intravenously along with erythromycin , he is responding to treatment

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1 child with high grade hyperpyrexia, bilat , bull swollen neck & inflamed lips. 2. With infection control & personnel protective equipment throat show thrush, severe acute inflammation, septic follicular tonsillitis & maybe diphtheria. & Septicemia and As per ECG changes percarditis, myocarditis. 3 ECG: sinustachy, St elevation ll , lll, avf, V5,6 . St depression in avr, V1,2 reciprocal changes . Urgent further evaluation and Rx Urgent Peaditrician, ENT & Cardiologist refrence. Need ICU isolation observation and monitoring, Maintain ABCDE and Vitals Oxygenation , Nebulisation - budecort, Duolin ENT Surgeon Maybe tracheostomy sos. Simultaneously Throat swab micro, c+s. Labtest cbc, clotting, RFT,LFT,Glucose. Cardiac enzymes, ECHO. Chest x-ray. Inj Parcetamol, Antibiotics, Antiemetics May need ionotropes Diphtheria antitoxin as per need. And as pt is responding to Rx, Continue further follow up, Evaluation and Rx...

Seviour sceptic follicular Tonsilitis. ECG. Sinus Mechanism. ST Elevated in inferior lead. ST Elevated in Latral lead to. ST flats depressed in V1 - V2 and AVR It is Reciprocal change . This is very critical condition of Pt. So Intensive menegment require. Starts Antibiotic and Do 2D.ECHO AND cardiac markers. And sent to interventional cardiologist .

A very rare case Acute follicular tonsillitis with Diphtheria, septicemia & Myocarditis. Intensive management is required in consultation with cardiologist.

Acute Follicular Tonsillitis with septicaemic Myocarditis.

ECG. Pericarditis

Myopericarditis

Membranous tonsillitis leading to myocarditis and septicemia. What is the ASO titre???

Throat swab microscopy and culture revealed corynebacterium diphtheria
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A throat swab for gm stain & culture could have been done just before start of therapy

Thank you.

Acute inferior wall mi

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