Diphtheria Flashcards
What cause diphtheria?
Corynebacterium diphtheriae
Where do you normally find diphtheria?
Tropics and subtropics
Outbreaks in displaced persons
What are the features of corynebacterium diphtheriae?
G+ve club shaped
Aerobic
How is diphtheria spread?
Respiratory droplets
What is the incubation period for diphtheria?
2-5 days
Can be infectious for 4 weeks
What is the pathogenesis of diphtheria?
Produces a toxin that stops protein synthesis leading to cell death
What are the clinical syndromes diphtheria can lead to?
Faucial/classical
Malignant
Cutaneous
Neurological
What are the symptoms of faucial diphtheria?
Moderate temp, malaise and sore throat
Pseudomembrane on tonsil that bleeds when pulled away
If spread to trachea/laryngeal:
Hoarse voice
Painful dysphagia
Dry cough
What are the symptoms of malignant diphtheria?
Rapid onset of bulls neck
Can lead to cardiac involvement- SOB, tachycardia, shock and heart block
What are the features of cutaneous diphtheria?
Chronic but mild
Variable lesions
Vesicular/pustular-> punched out ulcer
Painful
What are the features of neurological diphtheria?
Demyelinative neuropathy
3-8weeks after illness onset
Large range from soft palate paralysis to pharyngeal paralysis
How do you diagnose diphtheria?
Culture from lesions but treat on clinical suspicion
How do you treat diphtheria?
Diphtheria antitoxin
Macrolides/penicillin
Vaccination
Tracheostomy if airway concern
Serial ECGs
Supportive NGT/ventilation if neuro
Temporary pacing for cardio
What is the risk of diphtheria antitoxin?
Anaphylaxis
How do you follow up diphtheria treatment?
Test to eliminate after 14days of Abx, further 10 days if still positive
DTP3 vaccine
