Diphtheria -cause, clinical features treatment and prevention Custom Search Diphtheria is an acute infections disease usually affecting the upper respiratory tract and less commonly skin caused by a bacterium called Corynebacterium diphtheriae. The bacteria produce a toxin which is responsible for the disease. The disease has become rare due to routine immunization and is seen in those countries where immunization is not strictly practiced. People traveling to those places are at risk of contracting the disease. The toxin produced by the bacteria causes death of the cells lining the respiratory tract. These dead cells along with the inflammatory exudate form a grayish membrane over the tonsils, pharynx and larynx. The membrane is adherent to the underlying tissue and cannot be easily removed. Attempt to remove it may cause bleeding. The toxin can be absorbed into the blood and may damage other organs like heart, liver, adrenal gland and nerves. Damage to nerves causes paralysis (depending on the nerve involved the soft palate, eyes or limbs may be affected). Symptoms and signs: The incubation period varies from 2 days to one week. The disease starts with fever, sore throat and malaise. The pulse rate may be higher than expected for the degree of fever. Soon the characteristic membrane forms which may spread into larynx causing airway obstruction. The lymph nodes over neck are swollen. There may be slight swelling of the neck (bull neck). Skin lesions may appear as ulcers with membrane formation. Laboratory findings: Diagnosis is usually made on clinical observation. Direct smear from the throat may not show the organism. Special media is required for growing the organism by culture. White blood cells may be within normal limits. There may anemia and decrease in platelets. Treatment: Specific antitoxin should be administered within 48 hours. If given later it will be less effective. Patient should be admitted in a separate isolation ward. Penicillin G is the drug of choice. It should be given intravenously in a dose of 150,000 units per kilogram of body weight per day in divided doses for 10 days. If the patient is allergic to penicillin erythromycin may be used in a dose of 40 milligram per kilogram body weight per day in divided doses. Custom Search
Page last reviewed on 10th June 2010
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