Diphtheria

Etiologic agent

Toxin-producing strains of Corynebacterium diphtheriae.

Whether diphtheria bacteria produce toxin depends on infection

by a virus bacteriophage carrying the tox gene.

Source of infection

Diphtheria bacteria live in the mouth, nose, throat, or skin of infected persons.

Modes of Transmission

Diphtheria is transmitted from person to person by respiratory droplets or by direct contact with
the nasopharyngeal secretion of an infected person.

Contact with articles soiled with discharges from cutaneous lesions of infected people can be a
source of infection, but this has rarely been documented.

Raw milk has served as a vehicle for transmission

Incubation Period- The incubation period is usually 2–7 days, but may occasionally be longer.

Period of Communicability or Infectious Period

In untreated persons, the infectious period begins at symptom onset and extends through two
weeks after onset in the majority of patients (but may range up to six weeks post onset).

If patients are treated with antibiotics, communicability usually lasts less than four days.

Patients are considered infectious until 2 successive nose and throat cultures (and cultures of
skin lesions in cutaneous diphtheria), obtained more than 24 hours apart and at least 24 hours
after completion of antimicrobial therapy, are negative.

Asymptomatic carriers are important in sustaining transmission.

Treatment

• Hospitalization
• Intensive care treatment
• Bed rest
• Intravenous fluids
• Diphtheria antitoxin injection
• Antibiotics
• Tracheotomy
• Intubation
 • Artificial respiration
• Isolation to avoid contagion

Sign and symptoms

• Respiratory Diphtheria symptoms:

o Sore throat
o Low-grade fever
o Increased pulse
o Adherent membrane of the tonsils, pharynx, or nose
o Throat obstruction
o Neck swelling
o Enlarged neck lymph nodes
o Difficulty swallowing
o Extreme weakness
o Difficulty breathing
o High fever
o Arrhythmia
o Heart failure
o Muscle paralysis
• Cutaneous Diphtheria symptoms:
o Infected skin lesions
o Painful skin
o Red skin rash
o Swollen skin

Complication

• Myocarditis
• Arrhythmia
• Heart failure
• Peripheral neuritis
• The most severe complications can involve blockage of the air
passages:
o Bronchial obstruction
o Airway blockage
 o Hypoxia
o Death

Diagnosis

• Sore throat
• Streptococcal pharyngitis
• Oral candidiasis
• Infectious mononucleosis
• Viral pharyngitis (type of Pharyngitis)
• Necrotizing gingivostomatitis
• Cranial nerve neuropathy
• Motor nerver neuropathy
• Myocarditis

Pathognomic sign

Pseudumembrane of the tonsil

Meds of diphtheria

Erythromycine

Penicillin

Diphtheria anti toxin