Diphtheria: causes, symptoms, treatment

Diphtheria is a contagious upper respiratory tract infection caused by toxigenic diphtheria bacilli – Because the disease can endanger life, the only method of prevention is vaccination in the first years of life.


In the past, diphtheria was the leading cause of death among children. Currently, the disease is common in many countries in Asia, the South Pacific, the Middle East, Eastern Europe, Haiti and the Dominican Republic. Since 2011 outbreaks have occurred in Indonesia, Thailand, Laos, South Africa, Sudan and Pakistan.


About Corynebacterium diphtheriae

Corynebacterium diphtheriae bacillus are resistant to the external environment and to low temperatures. It can survive up to two weeks on objects in the environment, between 6 and 21 days in water and milk, up to 5-6 months in dry diphtheria membranes at room temperature and in dry soil – 3-5 months. The diphtheria bacillus is destroyed during boiling.


What is respiratory diphtheria

Bacteria that cause diphtheria are spread by air, through contact with infected persons or indirectly through contaminated objects. Usually, the bacteria multiply on the surface of the mucous membranes of the mouth or throat or near them, where they cause inflammation. This form of diphtheria is called respiratory diphtheria.


A milder form of diphtheria affects only the skin and appears especially in adults. This form is more common among people with poor hygiene. It spreads through contact with the wounds of the damaged skin.


What are the signs and symptoms of pharyngeal tonsil diphtheria?

The disease starts several days (5 days) after exposure to Corynebacterium diphteriae bacilli. In the first phase, diphtheria manifests through sore throat, hoarseness, poor general condition and fever (38 – 38.9 ° C). Children also experience accelerated heart rate, nausea, vomiting, chills and headaches. The lymph nodes in the neck are swollen, narrowing the airways and making breathing extremely difficult. Under these conditions, a pseudomembrane is formed on the amygdala, with a white-yellowish color.


How does laryngeal diphtheria manifest?

Laryngeal diphtheria is typically manifested through:


  • Coughing
  • Hoarseness, then loss of voice
  • Wheezing
  • Respiratory failure


Signs of anterior nasal diphtheria

Anterior nasal diphtheria manifests as a common cold. It is characterized by: nasal secretions, blood colored mucus. As a general rule, a white membrane forms on the nasal septum.


What are the complications of diphtheria

Toxic diphtheria bacilli – Corynebacterium diphteriae can affect certain nerves, especially those of the muscles of the face, neck, arms and legs, causing symptoms such as difficulty swallowing or paralysis of the arms or legs. These symptoms last for weeks. Corynebacterium diphteriae can also cause inflammation of the heart muscle (myocarditis), abnormal heart rhythms, heart failure and death. Severe infection can also damage the kidneys or cause high blood pressure.


How diphtheria is diagnosed

To confirm the diagnosis, a culture of the lesion is performed, because any angina with tonsil deposits will require bacteriological examinations. The sample should be taken from the pharyngeal area, especially from any discolored or ulcerated areas.


How to prevent diphtheria

Prophylaxis is done by administering trivaccine DTP (diphtheria-tetanus-pertussis). Children receive a total of 3 doses of vaccine, intramuscularly, at two, four and 11 months. They should be revaccinated at 6 years. After completion of the initial immunization program, diphtheria immunization (combined with tetanus) is recommended every 10 years.

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