Diphtheria

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Overview

Corynebacterium diphtheria is the causative agent of diphtheria. Corynebacterium diphtheria is a nonencapsulated, nonmotile, gram-positive bacillus that appears club-shaped. The predisposing factor for this disease is the failure to immunize during childhood. It mainly affects the respiratory system, integumentary system, or be present in an asymptomatic carrier state. Humans are the only hosts of the organism and are present in the upper respiratory tract. The organisms are transmitted via airborne droplets.


Exotoxins production is the key to the pathogenesis of the organism. The disease occurs mostly in the tropics but is prevalent worldwide with cases rarely seen in the United States. Patients present with the thick, gray, adherent pseudomembrane over the tonsils and throat. Diagnosis mainly involves isolating the organism, culturing the organism, and slowing toxin production. Management involves isolating the patient and treating with the antitoxin and antibiotics. Diphtheria vaccination is present in the regular vaccination schedule with diphtheria toxoid, which is given as a combination of diphtheria & tetanus toxoid, and acellular pertussis vaccine (DTaP).

Diphtheria is a serious infection caused by strains of bacteria called Corynebacterium diphtheriae that make toxin (poison). It can lead to difficulty breathing, heart failure, paralysis, and even death. CDC recommends vaccines for infants, children, teens, and adults to prevent diphtheria.


Symptoms

Diphtheria can infect the respiratory tract (parts of the body involved in breathing) and skin. Symptoms of diphtheria depend on the body part that is affected.


Photo of child with swollen neck due to diphtheria infection

A child with a swollen neck due to diphtheria infection.


Respiratory Diphtheria

The bacteria most commonly infect the respiratory system, which includes parts of the body involved in breathing. When the bacteria get into and attach to the lining of the respiratory system, it can cause:


Weakness

Sore throat

Mild fever

Swollen glands in the neck

The bacteria make a toxin (poison) that kills healthy tissues in the respiratory system. Within two to three days, the dead tissue forms a thick, gray coating that can build up in the throat or nose. Medical experts call this thick, gray coating a “pseudomembrane.” It can cover tissues in the nose, tonsils, voice box, and throat, making it very hard to breathe and swallow.

A thick, gray membrane covering the throat and tonsils.

A sore throat and hoarseness.

Swollen glands (enlarged lymph nodes) in the neck.

Difficulty breathing or rapid breathing.

Nasal discharge.

Fever and chills.

Tiredness.

Causes

Diphtheria is a serious infection caused by strains of bacteria called Corynebacterium diphtheriae that make a toxin (poison). It is the toxin that can cause people to get very sick.


Diphtheria bacteria spread from person to person, usually through respiratory droplets, like from coughing or sneezing.  People can also get sick from touching infected open sores or ulcers.

Diphtheria is a serious infection caused by strains of bacteria called Corynebacterium diphtheriae that make a toxin (poison). It is the toxin that can cause people to get very sick. Diphtheria bacteria spread from person to person, usually through respiratory droplets, like from coughing or sneezing.


Risk factors

Common risk factors in the development of diphtheria may include:

Lack of immunization.

History of contact with diphtheria patients.

Presence of skin lesions.

Presence of eczema.

History of chronic health conditions.

History of travel to areas endemic for diphtheria.

Overcrowding.

Exposure to poor sanitary conditions.

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Complications

Complications from respiratory diphtheria (when the bacteria infect parts of the body involved in breathing) may include:


Airway blockage

Damage to the heart muscle (myocarditis)

Nerve damage (polyneuropathy)

Loss of the ability to move (paralysis)

Kidney failure

For some people, respiratory diphtheria can lead to death. Even with treatment, about 1 in 10 patients with respiratory diphtheria die. Without treatment, up to half of patients can die from the disease.

Prevention

Keeping up to date with recommended vaccines is the best way to prevent diphtheria. In the United States, there are four vaccines used to prevent diphtheria: DTaP, Tdap, DT, and Td. Each of these vaccines prevents diphtheria and tetanus; DTaP and Tdap also help prevent pertussis (whooping cough).CDC recommends that close contacts of someone with diphtheria receive antibiotics to prevent them from getting sick. Experts call this prophylaxis. This is important for people with diphtheria infecting the respiratory system (parts of the body involved in breathing) and skin.