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Diphtheria — RACP Paediatrics MCQ

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HardInfectious DiseaseDiphtheriaRACP Paediatrics

A 15-year-old presents with sore throat, fever, massive tonsillar enlargement with a grey-white membrane, bull-neck lymphadenopathy, and myocarditis on ECG. He is recently arrived from a country where vaccination coverage is low. What is the diagnosis?

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Correct answer: D — Diphtheria

Diphtheria presents with pharyngeal pseudomembrane, bull-neck appearance (cervical lymphadenopathy/oedema), and toxin-mediated complications (myocarditis, neuropathy). It is rare in Australia due to vaccination. Treatment includes diphtheria antitoxin and antibiotics (penicillin or erythromycin). Urgent notification and contact tracing are required.

Reference: Australian Immunisation Handbook – 2025 – Diphtheria