The patient showed signs and symptoms of infection of the tissues near a fingernail (panaritium).
Swabs taken on the day of admission in hospital and on day 7 in another hospital, yielded toxigenic Corynebacterium diphtheriae.
On 30 Dec 2016, the World Health Organization (WHO) Global Reference Centre for Diphtheria and Streptococcal Infections at Public Health England (PHE), London, United Kingdom, confirmed the isolate as toxigenic C. diphtheriae (positive also by Elek test).
It has long been recognized that C. diphtheriae can cause clinical skin infections. Skin carriage of C. diphtheriae can act as a silent reservoir for the organism, and it has been found that person-to-person spread from infected skin sites is even more efficient than from the respiratory tract in causing classical respiratory diphtheria.
The carriage of tox-positive lysogenic C. diphtheriae also poses a risk that non-toxigenic strains, which are regularly found in Austrian residents, could become lysogenized by introduction of a beta-phage-bearing strain. (Colombo Gazette)