Diphtheria

Introduction
Clinical Features
Sign and symptoms :

Complications
Spread of infection
Management
diagnosis
Prevention
Secular Trends in the United States
Treatment
Introduction

Diphtheria is derived from the Greek diphthera, meaning leather hide. Diphtheria is an acute, toxin-mediated disease caused by the gram positive rod shaped bacteria Corynebacterium diphtheriae.

The most common sites of diphtheria infection are in the respiratory system. Infection primarily involving the tonsil(s), pharynx and/or larynx, low-grade fever, with or without an asymmetrical greyish-white adherent membrane of the tonsil(s), pharynx and/or nose. When the infection is at the larynx it causes tracheo bronchitis with hoarseness of voice, cough, stridor and croup.

Secondary infection involving the skin
May involve any mucous membrane

Classified based on site of disease
• anterior nasal
• pharyngeal and tonsillar
• laryngeal
• cutaneous
• ocular
• genital

diagnosis :
Laboratory confirmation requires isolation of diphtheria toxin-producing corynebacteria from a clinical specimen such as nose, throat and skin swabs. Laboratories must be informed that the sample is from a suspected case of diphtheria as selective media are required.

Complications
Most complications of diphtheria, including death, are attributable to effects of the toxin.

The toxin is responsible for the major complica¬tions of
• myocarditis (The most frequent complications of diphtheria)
• neuritis .
• low platelet counts (thrombocytopenia) and
• protein in the urine (proteinuria).

The severity of the disease and complications are generally related to the extent of local disease. The toxin, when absorbed, affects organs and tissues distant from the site of invasion

Vaccination Schedule and