infection

Diphtheria

definition
It is a serious bacterial infection caused by Corynebacterium Diphtheriae spread by airborne from droplets of sneezing and cough or by direct contact from the lesion of skin.it mainly infect the throat and cause white to gray membrane on the tonsil or the palate and pharynx . Incubation period about 7 days . main cause of the illness is due to toxins produced by the bacteria which once fix to the tissue, cannot be removed with treatment.
Mortality rate reaches 5% and increase if not treated early.

Clinical features

Fever and chills.
Sore throat and pain on swallowing.
Swelling of the neck (bull neck).
Cervical lymphadenitis.
True croup; stridor, brassy cough, hoarseness of voice,and may need intubation or tracheostomy for respiratory difficulty.
If not treated early may leads to cardiac toxicity and carditis and arrhythmia.and kidney problems.
Palatal paralysis and other cranial nerve paralysis or peripheral nerve paralysis

Laboratory investigations

Diagnosis depend upon the clinical suggestion followed by confirmation by lab tests.
Diagnostic test is to take swab from the throat and isolation of m.o by gram stain or
by culture of the bacteria from the swab.

prevention

Infection does not leads to permanent immunity and vaccine DTaP or dTaP give 10 yrs protective immunity from diphthria.
For contact give booster by DTaP for age <6 yr.
and dT vaccine booster for age above 6 yr

TREATMENT

PENICILLIN G injections for 14 days or erythromycin oral for 14 days .
Antitoxin should be given to inactivate toxins that still not combine with tissue yet. given IM or IV injection.