Diphtheria

Definition
• Acute infections caused by corynebacterium diphteriae.

Etiology
• Corynebacterium diphtheriae, namely gram-positive bacteria that are
polymorphous, immovable and do not form spores.
EPIDEMIOLOGY

Transmission is generally by air, in the form of droplet

infections, but it can also be through contaminated
objects or food.
PATOGENESIS
Basil lives FORMING
onRespiratory tract PSEUDOMEMBRAN
AND REMOVING
The upper part, EXOTOXY
vulva, earsAnd skin

Can arise locally / spread from the

Severe pharynx / tonsils to the larynx & the entire
symptoms respiratory tract above and throughout
the body through the bloodstream

Exotoxins can affect the heart and cause paralysis of the nerves /
peripheral nerves. Death is mainly caused by membrane blockage in the
larynx and trachea, respiratory failure or a complication of
bronchopneumonia
CLINICAL MANIFESTATION
• Shoot period 2-7 days.
• Common symptoms:Fever is not high (37-38,5C), lethargic, pale, headache &
anorexia, so the patient looks weak
• Local symptoms:Cold or pain swallowingShortness of breath with hoarseness &
stridor
• 1. diphtheria nose: cold, The secretions were mixed with a little blood from
pseudomembranes.
• 2. diphtheria in the pharynx and tonsils: Acute inflammation of the
throat,Pseudomembranes in the form of grayish spots extend to the nasopharynx
and larynx,Smelly breath,Swelling of the regional gland so that the neck looks like
a cow (ubullneck)
• 3. diphtheria in the larynx and trachea: Hoarseness & stridor,Severe
breathlessness, cyanosis and suprasternal and epigastric retraction,Enlargement
of regional glands which causes a bull neck
DIAGNOSIS :
• Diagnosis is based on clinical symptoms without
waiting for microbiological results
• The exact diagnosis depends on the results of direct or
culture preparations with corynebacterium
diphtheriae found
MANAGEMENT:

a. General treatment
Includes good care, complete rest in bed,
isolation of patients, close supervision of
possible complications.
b. Special treatment.
-Serum anti diphtheria (ADS)
-Antibiotics
- Corticosteroids
COMPLICATION:

• Respiratory tract: airway obstruction,

bronchopneumonia
• Cardiovascular: myocarditis due to bacterial
toxins
• Urogenital: Nephritis
• Nervous system
• PREVENTION
1. Isolation of sufferers:Patients must be isolated and can
only be discharged after a negative consecutive
examination of diphtheria germs.
2. Prevention of contact: Contact children with diphtheria
must be isolated for 7 days, If there are no clinical
symptoms, then immunization against diphtheria is
given.Immunization
3. DPT immunization
 PROGNOSIS

Death of sufferers is 3-5% and depends

on:
1. Age of sufferers
2. General condition of the sufferer
3. Location of diphtheria lesions