A 3-year-old presents with thick gray membrane over the tonsil extending to the soft palate, bull neck (cervical lymphadenopathy and soft tissue edema), and a low-grade fever. Gram stain of the membrane shows club-shaped bacilli in 'Chinese letter' arrangement. The MOST life-threatening immediate complication of this infection is:
- A Airway obstruction from membrane extension to the larynx and trachea ✓
- B Myocarditis from exotoxin
- C Palatal palsy
- D Peripheral neuropathy
Correct answer: A. Airway obstruction from membrane extension to the larynx and trachea
Explanation
Diphtheria (Corynebacterium diphtheriae) is an emergency due to the risk of airway obstruction when the tough, adherent gray pseudomembrane extends to the larynx and trachea ('croup' presentation). Airway obstruction is the most immediately life-threatening complication requiring urgent airway management. Myocarditis (exotoxin-mediated) is the most common cause of LATE death (1–2 weeks after onset), while palatal palsy and peripheral neuropathy are subacute neurological complications of the toxin.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.