Diphtheria in an Under-immunized Child in Rivers State, Nigeria: A Case Report

Background: Diphtheria is a potentially fatal, vaccine-preventable disease, with a recent resurgence from systematic challenges, particularly in resource-limited settings like Nigeria. This is a case report of the index case of diphtheria in the recent outbreak in Rivers State, in the Southern region of Nigeria. Case summary: A 3-year-old under-immunized girl presented with a seven-day history of fever and neck swelling at the children’s emergency unit of a tertiary health facility. Clinical evaluation, throat swab microscopy/culture, and PCR confirmed Corynebacterium diphtheriae infection. The patient’s management included antibiotics, diphtheria antitoxin, and respiratory support. Her condition rapidly deteriorated, and she died within a few days of presentation. Discussion: The fatal outcome of the index case highlights the critical role of vaccination in preventing diphtheria. Under-immunization, as in this case, underscores systemic challenges such as vaccine hesitancy, inadequate healthcare infrastructure, and limited public awareness, which contribute to the resurgence of vaccine-preventable diseases like diphtheria in Nigeria. Conclusion: Diphtheria is a life-threatening disease. Strengthening immunization programs, enhancing healthcare access, and implementing targeted public health campaigns are essential to address these gaps and prevent future outbreaks. This case serves as a reminder of the need for sustained efforts to improve vaccine coverage and public health education.