We had a child yesterday morning with severe trouble breathing. He was one of the sickest kids I’ve seen in a while. He was on oxygen but still really struggling to breathe; even pausing the flow of oxygen for a second made him frantic.

The thought crossed my mind that he could have some sort of obstruction – I thought about tracheitis, epiglottitis, a mass, etc. However, the thought of diphtheria, something you read about in old books, had never crossed my mind. I had not gotten to look in the frantic boy’s throat until V, my Haitian colleague, happened to show up mid-morning. He immediately grabbed a tongue depressor so we could take a look. Sure enough, there was the scary grey membrane they talk about covering the throat – he had diphtheria!

I had to admit that I had never seen diphtheria before. It is a disease that is virtually never seen in the US, thanks to vaccination. We called the local health department to get antitoxin and had already started erythromycin – an appropriate antibiotic for diphtheria.

We wound up transferring the child to another hospital for more intensive management, knowing how close to respiratory failure he was. It wasn’t until mid-afternoon that I got a text from V reminding me of something else I had forgotten about that old-fashioned disease – exposed contacts need prophylaxis and a vaccine booster. So today V and I will roll up our sleeves at the vaccine clinic, and I’ve started my own course of erythromycin last evening.

Never a dull moment here in Saint Marc!

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  1. Uncle Dick

     /  January 28, 2013

    So much to learn every day, especially in the situations you face. Easy for me to say be careful but I know you are.

    Uncle Dick

  2. Jan Holzhauer

     /  January 28, 2013

    That Dr. V does come in handy 🙂 jan

  3. You can think of the booster shots as just a lesson in empathy… and it means you are allowed to go get yourself a lollypop.


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