DI

P
H
By:
T ELGARIO, Mariane
H IBAAN, Shyluck May
E RABOY, Mario Elizer
RI RAPACON, Jobelle

A
DEFINITION:
 acute contagious disease characterized by
general toxemia emanating from localized
inflammatory process characterized by the
formation of “pseudomembrane” commonly
in the face area & tonsils, & the elaboration
of a powerful exotoxin affecting the impt.
viscera as the heart & kidneys & the
peripheral nervous system.
CAUSATIVE AGENT:
 Corynebacterium diphtheriae or Klebs Loffler
bacillus > gram positive rod
RESERVOIR: Man
SOURCE: Discharges or secretions from nasopharynx
MODES OF TRANSMISSION:
Direct contact – discharges form respiratory
passages; saliva
Indirect contact – though various articles including
toys & clothing contaminated by infected
individual
INCUBATION PERIOD:
1 to 7 days
PERIOD OF COMMUNICABILITY:
2 to 4 weeks, average: 2 weeks
SIGNS AND SYMPTOMS:
 fever,
 red sore throat,
 weakness,
 Headache
 difficulty swallowing, or
 difficulty breathing
 dryness & excoration of upper lip & nares
 bull neck appearance
 Laryngeal stridor
 Hoarseness of voice

“PSEUDOMEMBRANE” > Hallmark sign ( thick gray

covering in the back of throat that can make breathing
difficult)
DIAGNOSTIC EXAM:
 Nose & throat culture – there must be 3
consecutive (-) result
 Schick’s test – determine susceptibility &
immunity to diphtheria.
 Molony test – determine hypersensitivity to
diphtheria anti-toxin
TREATMENT:
 Drugs
 (ADS) anti-diphtheria serum à to neutralize
toxins = IM, IV ANST
 Antibiotics – Penicillin G. Sodium, Eythromycin to
kill the causative agent
 Supportive
 O2 inhalation
 Tracheostomy
 Suction secretions
NURSING CARE:
 TSB for fever
 Provide liquid to soft diet with minimal
CHON & sufficient CHO
 Strict isolation
 CBR – no early ambulation
 Increase fluid intake
 Small frequent feedings
 Maintain patent airway
 Proper disposal of naso-pharyngeal secretions
 Diversional activities to children
COMPLICATIONS:
 Myocarditis – dec apical pulse < 60 lead to
cardiac arrest.
 Peripheral neuritis
 Broncho pneumonia
 Encephalitis
 Cerebral Infarction
 Renal Function
 Shock
PREVENTION:
 Avoid MOT
 Immunization – DPT 0.5cc IM – vastus lateralis
given at the same time with OPV 6,10,14 wks
after DPT don’t massage to prevent lump
forming
put hot moist compress if with lump formation
 expect fever within 24 hrs -- give Paracetamol
q4hours for 24 hours
 check patient's temp before giving DPT
 don't give succeeding doses if patient
experienced convulsion