Concurrent diphtheria and COVID-19 infection in an unvaccinated child

We report the case of a girl in her middle childhood who presented with progressive neck swelling, sore throat, dysphagia, low-grade fever and malaise, and with no prior vaccinations. Examination revealed a 'bull neck' appearance with pseudomembranous pharyngitis, which showed bleeding on membrane removal. The patient did not have any respiratory distress, but RT-PCR confirmed the concurrent coinfection of DPT with SARS-CoV-2. The laboratory investigations exhibited a leucocyte count of 17.2 × 10⁹/L and ALT raised at 113 U/L, indicative of systemic involvement. Imaging showed mild tonsillar calcifications with ground-glass opacities on the chest CT, which placed a CT severity score for cough severity of 13/25, indicating moderate COVID-19 pneumonia. Treatment was intravenous DPT antitoxin (100 000 units) and cefotaxime (1 g two times per day for 14 days). Symptomatic resolution occurred within 10 days, including clearing inflammatory markers and membranes. Recovery was complete and uncomplicated, with no sequelae after 3 months.