id	author	title	date	pages	extension	mime	words	sentence	flesch	summary	cache	txt
ajlm-2802	Masemola, Kgaogelo R.	From neglect to necessity: The case for routine work-up of nontoxigenic Corynebacterium diphtheriae in clinical microbiology	2025		.htm	text/html	2119	119	27	In the 1980s and 1990s, outbreaks and case clusters were documented in various regions.4,8 By the mid-1990s, experts were already warning of the resurgence of C. diphtheriae and the rise of nontoxigenic C. diphtheriae in hospital settings.4 Studies and surveillance reports have indicated that nontoxigenic C. diphtheriae infections are rising, often linked to intravenous drug use, homelessness, and skin infections.7,9 TABLE 1: Selected reported outbreaks and case series of nontoxigenic Corynebacterium diphtheriae. Cutaneous diphtheria manifests as chronic, non-healing ulcers, or sores, which often serve as reservoirs for transmission.10,14 Invasive bloodstream infection and endocarditis are the most severe form of nontoxigenic C. diphtheriae disease, with a high mortality rate.1,8 Septic arthritis and osteomyelitis are less common, but are serious infections which often occur in the context of trauma or injection drug use.16 Nontoxigenic strains do not cause classic respiratory diphtheria, but they can colonise the throat and cause sore throat or tonsillitis.6 Other rare manifestations of nontoxigenic C. diphtheriae are pneumonia, urinary tract infections (especially in catheterised patients), and other localised infections.3,15 Patient outcomes The mortality associated with nontoxigenic C. diphtheriae infections varies depending on the type and severity of the infection, as well as patient-specific factors.3	cache/ajlm-2802.htm	txt/ajlm-2802.txt