diphtheria

Diphtheria is a serious bacterial infection that affects the mucous membranes of the nose and throat. It is caused by the bacterium Corynebacterium diphtheriae, which produces a toxin that causes inflammation and damage to the affected tissues.

Symptoms:

• Severe inflammation of the nose, throat, and windpipe (trachea)
• Breathing and swallowing problems
• Formation of a grayish membrane covering the tonsils and upper part of the throat
• Respiratory symptoms or non-respiratory forms can occur

Diphtheria is highly contagious and can be transmitted from person to person through respiratory droplets. The infection can also cause complications such as heart and nervous system problems.

Types:

• Respiratory diphtheria (affecting the throat and air passages)
• Non-respiratory diphtheria (affecting other parts of the body)

Causes:

• Infection with Corynebacterium diphtheriae
• Production of toxin by the bacteria

Prevention:

• Vaccination against diphtheria is widely available and effective in preventing the disease.
• Practicing good hygiene, such as washing hands regularly and avoiding close contact with infected individuals.

Diphtheria is a serious disease that can be fatal if left untreated. Prompt medical attention is essential for diagnosis and treatment.

References:

• [1] Diphtheria is an infectious disease that occurs due to C. diphtheriae. It is the toxin this bacterium produces ... The infection can transmit from a person with the infection to any mucous membrane in another person. Specific signs and symptoms of diphtheria depend on the particular variant ... [7]
• [2] Diphtheria is an acute febrile contagious disease typically marked by the formation of a false membrane especially in the throat and caused by a gram-positive bacterium (Corynebacterium diphtheriae) that produces a toxin causing inflammation of the heart and nervous system. [11]
• [3] Diphtheria is an acute infection caused by the bacterium Corynebacterium diphtheriae. Alternative Names. Respiratory diphtheria; Pharyngeal ... [12]
• [4] Diphtheria is a serious bacterial infection that affects the mucous membranes of the throat and nose. [13]

Diphtheria Signs and Symptoms

Diphtheria is a bacterial infection that can cause a range of symptoms, from mild to severe. Here are some common signs and symptoms of diphtheria:

• Respiratory Tract Infection: The majority of people with diphtheria will experience a respiratory tract infection, which may manifest as a sore throat and low-grade fever in the first few days of the illness [8].
• Sore Throat: A sore throat is one of the most common symptoms of diphtheria, often accompanied by difficulty swallowing (dysphagia) [3]. The soreness can be severe and may lead to a thick grey-white coating on the back of the throat, nose, and tongue [6].
• Fever: A high temperature (fever) is another common symptom of diphtheria, often accompanied by chills [2].
• Swollen Glands in the Neck: Swelling of the neck glands is a common sign of diphtheria, which can be painful and tender to touch [5].
• Difficulty Swallowing (Dysphagia): Difficulty swallowing food or liquids due to a sore throat or swollen tonsils can occur in some cases [4].
• Malaise: A general feeling of being unwell or weak is also a symptom of diphtheria, which can be accompanied by loss of appetite and fatigue.
• Skin Infection: In rare cases, diphtheria can cause a skin infection, characterized by an open sore or ulcer with a clear edge, pain, rash with scales or peeling skin, redness, and swelling [1].

It's essential to seek medical attention immediately if you suspect someone has contracted diphtheria. Early diagnosis and treatment are crucial in preventing complications and reducing the risk of transmission.

References: [1] Feb 12, 2024 — Diphtheria skin infection [2] Symptoms [3] Feb 12, 2024 — Respiratory diphtheria [4] Difficulty swallowing (dysphagia). Nerve, kidney or heart problems (if the bacteria enters your bloodstream). [5] Jul 12, 2024 — Common symptoms include fever, sore throat and swelling of the neck glands. [6] Symptoms of diphtheria · a thick grey-white coating that may cover the back of your throat, nose and tongue [7] Symptoms often come on fairly gradually, beginning with a sore throat and fever. In its early stages, diphtheria may be mistaken for a severe sore throat. [8] The majority of people with diphtheria will have a respiratory tract infection, with a sore throat and low grade fever in the first few days of the illness.

Diagnostic Tests for Diphtheria

Diphtheria, a bacterial infection caused by Corynebacterium diphtheriae, can be diagnosed through various tests. Here are some of the diagnostic tests used to confirm diphtheria:

• Medical History and Physical Examination: A healthcare provider will take a medical history, including immunization status and travel history, and perform a physical examination to assess symptoms such as respiratory tract or cutaneous infection [6].
• Swab Test: A swab is taken from the back of the throat or from a sore to collect a sample for laboratory testing [7].
• Gram Stain or Throat Culture: Laboratory tests can identify Corynebacterium diphtheriae through Gram stain or throat culture, but identification alone is not enough for diagnosis confirmation [2].
• Toxin Assay: A toxin assay test detects the presence of the toxin made by the bacteria [13].
• Elek Test: The Elek test is used to confirm toxigenicity and should be done without delay on any suspected case [3].
• Molecular Methods: The Centers for Disease Control and Prevention (CDC) uses culture and molecular methods, along with a specialized toxin production test, to confirm diphtheria diagnoses [2].

These diagnostic tests help healthcare providers confirm the presence of diphtheria and provide appropriate treatment.

References: [1] - October 6, 2023 [2] - May 7, 2024 [3] - by A Efstratiou · 2000 · Cited by 166 [6] - June 6, 2024 [7] - June 6, 2024 [13] - Exams and Tests​​

Treatment Options for Diphtheria

Diphtheria, a highly contagious bacterial infection, requires prompt medical attention to prevent complications and death. The primary treatment options for diphtheria involve the use of antibiotics and antitoxin.

• Antibiotics: Erythromycin or penicillin are recommended as first-line treatments for respiratory and cutaneous diphtheria [1]. Antibiotics help eliminate the bacteria causing the infection, reducing the production of toxin and limiting the contagious period.
• Diphtheria Antitoxin (DAT): DAT is a crucial component in treating respiratory diphtheria. It neutralizes the circulating toxin, preventing further damage to the body [9]. However, antitoxin is not typically needed for cutaneous diphtheria.

Additional Treatment Considerations

• Chemoprophylaxis: Close contacts of individuals with diphtheria must receive chemoprophylaxis (antibiotic treatment) regardless of their immunization status or age [2].
• Supportive Care: Patients may also require supportive care, including antihistamines, non-steroidal anti-inflammatory drugs, and corticosteroids to manage symptoms and complications [5].

Importance of Early Treatment

Early initiation of antibiotic coverage is essential in limiting toxin production and reducing the contagious period. Prompt treatment can significantly improve patient outcomes and prevent further transmission.

References:

[1] Respiratory and cutaneous diphtheria: Only erythromycin or penicillin is recommended. [2] Close contacts, such as family members, household contacts, and potential carriers, must receive chemoprophylaxis regardless of immunization status or age. [5] Medications that may be helpful include antihistamines, non-steroidal anti-inflammatory drugs, and corticosteroids. [9] Diphtheria antitoxin is given as a shot into a muscle or through an IV (intravenous line).

Differential Diagnosis of Diphtheria

Diphtheria, a bacterial infection caused by Corynebacterium diphtheriae, can be challenging to diagnose due to its similarity in symptoms with other conditions. The differential diagnosis of diphtheria involves identifying and ruling out other possible causes of the patient's symptoms.

Possible Differential Diagnoses:

• Streptococcal pharyngitis (Strep Throat): This bacterial infection, caused by Group A Streptococcus, can present with similar symptoms to diphtheria, including sore throat and fever. [4]
• Peritonsillar abscess: A collection of pus behind the tonsils that can cause severe sore throat and difficulty swallowing. [5]
• Follicular tonsillitis: An inflammation of the tonsils characterized by small white or yellowish spots on the surface of the tonsils. [5]
• Pseudo diphtheria: A condition that mimics the symptoms of diphtheria but is not caused by Corynebacterium diphtheriae. [5]
• Acute epiglottitis: An inflammation of the epiglottis, a flap-like structure at the back of the throat, which can cause severe sore throat and difficulty swallowing. [2]
• Infectious mononucleosis: A viral infection caused by Epstein-Barr virus that can present with symptoms similar to diphtheria, including sore throat and fever. [6]

Other Conditions:

• Cutaneous diphtheria: A rare form of the disease that affects the skin, which can be confused with other skin conditions such as pyoderma gangrenosum. [9]
• Respiratory tract infections: Other bacterial or viral infections that can cause symptoms similar to diphtheria, including fever and sore throat. [2]

Key Points:

• Diphtheria is a bacterial infection caused by Corynebacterium diphtheriae.
• The differential diagnosis of diphtheria involves identifying and ruling out other possible causes of the patient's symptoms.
• Common differential diagnoses include streptococcal pharyngitis, peritonsillar abscess, follicular tonsillitis, pseudo diphtheria, acute epiglottitis, and infectious mononucleosis.

References:

[1] Apr 26, 2024 — Differential Diagnoses · Angioedema · Emergent Management of Pediatric Epiglottitis · Epiglottitis · Infective Endocarditis · Infectious ...

[2] Jul 29, 2020 — Respiratory diphtheria must be differentiated from respiratory tract or other infections that present with fever, neck swelling, cough and/or ...

[3] by LF Barroso · Cited by 6 — SUMMARY AND RECOMMENDATIONS · INTRODUCTION · CLINICAL MANIFESTATIONS · Respiratory diphtheria · Systemic manifestations · DIAGNOSIS · Approach to ...

[4] Oct 2, 2024 — Differential Diagnosis. Acute Sore Throat. Bacterial infections. Streptococcal pharyngitis (Strep Throat); Neisseria gonorrhoeae; Diphtheria (C.

[5] by HH Lott · 1926 — 485) the differential diagnosis of diphtheria should be made between a. peritonsillar abscess; b. follicular tonsil- litis; c. pseudo diphtheria; d. pseudo ...

[6] Diphtheria images. Differentials. Streptococcus pyogenes pharyngitis; Acute epiglottitis; Infectious mononucleosis. More Differentials. Guidelines. Child and ...

[7] Doctors may suspect diphtheria in a sick child who has a sore throat with a gray membrane covering the tonsils and throat. Growth of C. diphtheriae in a lab ...

[8] The differential diagnosis of respiratory diphtheria (i.e. pharyngeal, laryngeal, anterior nasal) includes infection with other pathogens that can cause ...

[9] What is the differential diagnosis for cutaneous diphtheria? · Pyoderma gangrenosum — a rapidly enlarging, painful ulcer with an undermined edge · Cutaneous ...