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January 31, 1942


JAMA. 1942;118(5):380-381. doi:10.1001/jama.1942.02830050042013

Studies of production of toxin by malignant strains of Corynebacterium diphtheriae recently reported by O'Meara1 of Trinity College, Dublin, and by Mueller2 of Harvard University have led to a new and clinically plausible theory of the etiology of diphtheria gravis. The optimism that prevailed during the first three decades of the twentieth century with regard to the successful therapeutic control of diphtheria yielded to pessimism and perplexity with the appearance in 1927 of numerous cases of malignant diphtheria in central Europe. Such cases were wholly refractory to routine methods of serum therapy. In certain Berlin hospitals, for example, the diphtheria mortality rose from the previous statistical level of 5 per cent to approximately 30 per cent. Similar high mortalities were afterward reported from France, Czechoslovakia, Italy and Rumania, with a later spread of the epidemic to the British Isles.3

The malignant cases of diphtheria were characterized by

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