About Diphtheria

Overview

Diphtheria is a highly contagious bacterial infection caused by variants of Corynebacterium diphtheriae. It primarily affects the respiratory system or the integumentary system, which includes the skin, glands, nails, and hair. Common symptoms include a thick, gray coating in the nose and throat, along with a sore throat, swollen glands, weakness, and mild fever. In some cases, diphtheria can also cause ulcers and open sores on the skin. The most serious complications arise from the production of a toxin called an exotoxin by certain variants of the bacterium. This toxin inhibits protein production and leads to cell and tissue death. If the toxin enters the bloodstream, it can damage the kidneys, heart, and nerves, resulting in conditions like myocarditis (inflammation of the heart muscles) and neuropathy (nerve damage). Vaccination is the best way to prevent diphtheria.

Causes and Risk Factors

Diphtheria is caused by an infectious bacterium called C. diphtheriae. The bacterium produces a toxin that leads to severe illness. The causes of diphtheria include:

• Direct physical contact with respiratory droplets from coughing or sneezing
• Contact with secretions from the nose and throat, such as mucus and saliva
• Contact with infected skin lesions

Risk factors for diphtheria include:

• Increasing age
• Genetic predispositions, such as a positive family history of diphtheria or related diseases
• Previous history of polyps
• Inflammatory bowel diseases (Crohn's disease and ulcerative colitis)

Having risk factors does not mean people with get diptheria. Risk factors only increase a person’s chances of getting the disease. It's important to consult with your healthcare professional for personalized advice on managing risk factors.

Symptoms

Common symptoms of diphtheria include:

• Sore throat
• Mild fever (101 degrees Fahrenheit or less)
• Chills
• Swollen neck glands

As the disease progresses, other symptoms may occur, such as:

• Hoarseness
• Thick coating in the back of the nose or throat (white or grayish)
• Difficulty breathing or swallowing
• Nerve damage
• Renal (kidney) failure
• Inflammation of the heart myocardium

In severe cases, especially in young children, diphtheria can be fatal even with treatment. It is important to note that diphtheria is highly contagious and can be transmitted through airborne means or direct contact with an infected person's droplets. Vaccination is the best form of prevention against diphtheria. If you experience any symptoms of diphtheria, it is crucial to seek medical attention promptly for diagnosis and treatment.

Diagnosis

To diagnose diphtheria, the following examinations, tests, and procedures are commonly performed:

• Physical exam: The healthcare provider will check for symptoms such as a thick gray coating in the throat or nose, swollen lymph nodes in the neck, and difficulty breathing or swallowing. These often indicate a possible diphtheria infection.
• Lab tests: Doctors may take a throat or nasal swab to test for the bacteria causing diphtheria. Polymerase chain reaction (PCR) testing can also be done on these specimens to quickly identify whether the bacteria are present and if they produce toxins. Blood tests may be used to help assess complications or overall health.
• Imaging studies: In severe cases, imaging tests such as X-rays or MRI (magnetic resonance imaging) scans may be recommended to evaluate complications cause by the infection. These can assess blockages in the airway, lung involvement, or damage to other organs such as the heart or nervous system.

Additional examinations, tests, and procedures may be performed based on initial findings or individual factors. These may include specialized tests depending on the body system being evaluated. For example, cardiac tests may evaluate heart involvement, or neurological tests may check for nerve damage.

Remember to consult with your healthcare provider for personalized advice regarding examinations, tests, and procedures for diagnosing and determining the severity of diphtheria.

Treatment Options

The goals of treatment for diphtheria are to:

• Neutralize the bacteria's toxins: Diphtheria antitoxin, also known as anti-diphtheritic serum, is used to counteract the toxins produced by the bacteria. This treatment is crucial for respiratory diphtheria infections. The antitoxin works by neutralizing the toxins and preventing them from causing further harm to the body.
• Eliminate the bacteria: Antibiotics such as erythromycin or penicillin are used to kill and eradicate the diphtheria-causing bacteria. These antibiotics are effective in treating both respiratory and skin infections. It is important to complete the full course of antibiotics to ensure complete removal of the bacteria from the body. Stopping too early can allow the bacteria to survive and cause the infection to come back or spread to others.
• Isolating patients for 48 hours after antibiotics have been started: This is done to prevent spreading the infection to others

Diphtheria antitoxin works by neutralizing bacterial toxins, while antibiotics kill and eliminate the bacteria from the body. Health behavior changes, such as completing the full course of antibiotics, are important for successful treatment.

Remember, always consult with your healthcare professional for personalized advice and guidance regarding your specific situation.

Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Side effects can occur. Check with your health care professional or read the information provided with your medication for side effect information.