Diphtheria is caused by the corynebacterium diphtheriae bacterium. It’s most commonly spread through person-to-person contact or contact with items that have the bacteria on them. Coming into contact with items such as an infected person’s cup or used tissue can transfer the bacteria. The mist exhaled by an infected person’s sneeze or cough can also contain the bacteria. Even if the infected person does not show any signs or symptoms of diphtheria, he or she is still able to transmit the infection for up to six weeks. Diphtheria is a bacterial infection that affects the membranes of the throat and nose. Although it spreads easily, diphtheria can be prevented through the use of vaccines. If left untreated, diphtheria can cause severe damage to your kidneys, nervous system, and heart.
The symptoms of diptheria appear usually after 3-4 days of infection. The most common and visible symptom is a thick, gray coating on throat and tonsils. Other common symptoms include:
•swollen lymph nodes in the neck
•a loud,barking cough
•a sore throat
•a general feeling of uneasiness or discomfort
•Upper respiratory tract infections
The diagnosis is carried out initially by physical examination of swollen lymph nodes.The differential diagnosis includes a checkup of presence of following conditions such as:angioedema, epiglottis,infective endocarditis,myocarditis, septic shock,rheumatic fever etc. To establish the diagnosis of C diphtheriae, it is vital to both isolate C diphtheriaein culture media and to identify the presence of toxin production. Urinalysis (UA) may demonstrate transient proteinuria. Chest radiograph and soft tissue neck radiography/CT or ultrasonography may show prevertebral soft tissue swelling, enlarged epiglottis, and narrowing of the subglottic region. Echocardiography may demonstrate valvular vegetations; however, this systemic manifestation of diphtheria is rare. reatment of diphtheria should be initiated even before confirmatory tests are completed due to the high potential for mortality and morbidity. Secure definite airway for patients with impending respiratory compromise or the presence of laryngeal membrane. Diphtheria antitoxin is a horse-derived hyperimmune antiserum that neutralizes circulating toxin prior to its entry into the cells.
According to the World Health Organization (WHO), diphtheria epidemics remain a health threat in developing nations. This epidemic caused more than 157,000 cases and 5000 deaths according to WHO reports. Disproportionately high rates of death were observed in individuals older than 40 years, and 5,000 deaths were reported. This epidemic accounted for 80% of cases reported in Ireland. The most widely quoted diphtheria mortality rate is 5-10%. It may reach higher than 20% in children younger than 5 years and adults older than 40 years.