Diphtheria is a serious bacterial infection. It usually affects the nose and throat and causes a bad sore throat, swollen glands, fever and chills. It is caused by a bacteria named Corynebacterium diphtheriae. But the hallmark sign is a thick, gray covering in the back of your throat that can make breathing difficult. Diphtheria can also infect your skin. Years ago, diphtheria was a leading cause of death among children. Today, diphtheria is very rare in the United States and other developed countries thanks to widespread vaccination against the disease. Fewer than five cases occur in the United States each year, but diphtheria bacteria still exist in the world and can cause outbreaks if vaccination is inadequate. The bacteria that cause diphtheria are usually spread in droplets of moisture coughed into the air. Usually the bacteria multiply on or near the surface of the mucous membranes of the mouth or throat, where they cause inflammation. Some types of Corynebacterium diphtheriae release a potent toxin, which can damage the heart, kidneys, and nervous system. A milder form of diphtheria affects only the skin and occurs mainly in adults. This form is more common among people with poor hygiene (for example, homeless people).
Diphtheria is a bacterial infection that affects the tonsils, pharynx, larynx, nose, and skin . It produces a thick membrane which covers the area of inflammation. Children under 5 and adults over 60 years old are particularly at risk for contracting the infection. People living in crowded or unclean conditions, those who aren’t well nourished , and children and adults who don’t have up-to-date immunizations are also at risk. Diphtheria is rare in the United States and Europe, where health officials have been immunizing children against it for decades.
Causes of Diphtheria
Transmission usually occurs through intimate contact or by airborne respiratory droplets from asymptomatic carriers or convalescing patients; many more people carry this disease than contract active infection. The most serious complications are caused by a toxin produced by the diphtheria bacterium that can damage the heart, nervous system and, less often, the kidneys. Very rarely, food contaminated with the diphtheria bacterium can infect others. Diphtheria usually occurs in children of preschool age. Diphtheria may also be spread via the bloodstream to other organs, where it can cause significant damage. The bacteria primarily infect the nose and throat, although they may initially infect the skin, and producing skin lesions. Skin diphtheria causes a nasal discharge and excoriated skin around the nose.
Adults older than 60 years of age and who have not received immunization are at an increased risk of the disease.
due to lack of routine immunization among the children aged 6-12 months the disease incidence increased drastically.
Compromised host, individuals addicted to alcohol and illicit drug users are at an increased risk of diphtheria.
Homosexual men have increased incidence rates.
Diphtheria is most common in areas where people live in crowded conditions with poor sanitation.
Signs and Symptoms of Diphtheria
There are two types of diphtheria. One type involves the nose and throat, and the other involves the skin. Symptoms of diphtheria include sore throat, fever and swollen lymph glands in the neck. In many cases, a grey membrane grows across the throat making breathing difficult. It can also affect the skin, called cutaneous diphtheria, where sores can develop. Diphtheria can lead to breathing problems, heart failure, paralysis and sometimes death.
Fever.
Hoarseness .
Chills.
No breathing.
Bluish coloration of the skin.
Painful swallowing.
A sore throat.
Croup-like coughing.
Fatigue.
Swollen glands.
Treatment for Diphtheria
Certain antibiotics, such as penicillin and erythromycin, can be prescribed for the treatment of diphtheria. A diphtheria antitoxin is also used for treatment. Patients are isolated and intensive care support may be needed if the heart, kidneys, or nervous system have been affected. Patients who have recovered are given a full course of diphtheria vaccine. Other treatment will depend on the clinical status of the victim. It may be minimal or critical care may be required. Most need tube feedings and frequent suctioning. Some need a tracheostomy. Strict bed rest is recommended for all those with diphtheria for at least 2 or 3 weeks, with heart monitoring at least several times a week for a month or more to detect any damage to the heart.
DTP (Diphtheria-Tetanus-Pertussis) and DTaP (Diphtheria-Tetanus-acellular Pertussis ) vaccines are designed to prevent the diptheria.
Penicillin or erythromycin may also be given, particularly to guard against complicating factors such as pneumonia or streptococcal infection.
Diphtheria infection doesn’t confer immunity, therefore diphtheria immunization should be given during convalescence.
Treatment must not wait for confirmation by culture. Treatment with antitoxin is begun as early as possible. People with diphtheria may be require hospitalization for supportive treatment and during the administration of antitoxin.
If the membrane in the back of the throat obstructs breathing, a tube may be passed through the mouth or nose; in very serious cases, a tracheostomy may be needed.
