DIPHTHERIA

Is a contagious disease spread by direct physical contact or breathing aerosolized secretions of infected individuals.

TRANSMISSION

Droplets from an infected person.

CAUSATIVE AGENT

1.       Corynebacterium diphtheria.

2.       Diphtheria bacillus

Incubation period is 2- 6 days.

PATHOPHYSIOLOGY

1.       Invasion of the local tissues of the throat, which requires colonization and subsequent bacterial proliferation.

2.       Toxigenesis: bacterial production of the toxin.

CLINICAL FEATURES

         i.            Sore throat

       ii.            Pharyngitis

     iii.            Difficulty in breathing

     iv.            Stridor

       v.            Nasal discharge may be bloody

     vi.            Hypoxia

    vii.            Painful swelling of the neck

  viii.            High pitched cough

      ix.            Fever

       x.            Drooling

      xi.            Husky voice/ Hoarseness

    xii.            Skin lesions in cutaneous diphtheria

  xiii.            Croup- like (barking) cough

  xiv.            Pseudo membrane covering the tonsils.

DIAGNOSTIC TEST

1.       Physical examination

2.       Gram stain/ throat culture

MANAGEMENT

1.       As soon as is detected, start treatment even before test results are available.

2.       Anti- diphtheria antitoxin given as a shot into the muscle/ IV.

3.       Antibiotics (erythromycin, penicillin)

4.       Fluids by IV

5.       Oxygen therapy

6.       Bed rest

7.       Intubation

8.       Tracheostomy

COMPLICATIONS

1.       Myocarditis/ endocarditis

2.       Peripheral neuritis

3.       Shock

4.       Cerebral Infarction with hemiplegia

5.       Super infection of lungs

6.       Purpuric skin eruptions

7.       Bacteraemia

8.       Meningitis

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