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February 23, 1924

A CASE OF NASAL DIPHTHERIA WITH MISLEADING HISTORY

JAMA. 1924;82(8):631. doi:10.1001/jama.1924.26520340004014f

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Abstract

Epidemiologists regard the epipharynx or postnasal space as the habitat of the germs in most of our diphtheria carriers. We all know the infrequency of culture taking from this recess, the attendant difficulties when the attempt is made, particularly in children, not only in private but also hospital practice, and the persistent positive culture in spite of antitoxin and hygienic measures to remove it.

The same thing can be said of nasal diphtheria, often present without external nares signs and logically diagnosed as a common rhinitis or "cold." How excusable, then, with a traumatic history, as illustrated by the case here reported.

REPORT OF CASE  A. L., a boy, aged 9 years, was in a slight automobile accident, July 20, 1923 The boy returned home with nosebleed, which recurred frequently, with a closing feeling of the nostrils. A week later a physician prescribed a wash to be sprayed into the

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