DIPHTHERIA

Question 1

Diphtheria commonly affects….

Answer 1

Tonsils
Skin

Question 2

Transmission of diphtheria

Answer 2

Respiratory droplet from person to person
Skin contact (rare)

Question 3

Infected patients may recover after initial symptoms and signs or develop severe symptoms and die within 6-10 days. T/F

Answer 3

True

Question 4

Complications of diphtheria

Answer 4

Abnormal heartbeat
Heart failure
Damage to heart valves
Respiratory obstruction leading to death

Question 5

Cause of diphtheria

Answer 5

Corynebacterium diphtheriae

Question 6

Symptoms of diphtheriae

Answer 6

Sore throat
Loss of appetite
Slight fever
Dysphagia
Difficulty in breathing with or without stridor

Question 7

Signs of diphtheriae

Answer 7

Greyish white membrane or patch in the throat and on tonsils within 2-3 days of the onset of symptoms. Membrane may bleed, become greyish green or black

Question 8

Investigatins in diphtheriae

Answer 8

Throat/nasal swabs for culture for index case and close contacts
Repeat swabs after antibiotic treatment course

Question 9

Treatment objectives in diphtheriae

Answer 9

To neutralise the effect of circulating antitoxins before they become
fixed to the tissues
To provide supportive care respiratory and feeding where indicated
To eradicate the organism from the pharynx
To prevent spread

Question 9

Pharmacological management of diphtheriae

Answer 9

Diphtheria antitoxin
and
Benzylpenicillin
then
Amoxicillin or Azithromycin

Question 10

Non-pharmacological interventions in diphtheriae

Answer 10

Bed rest
Feeding by nasogastric tube for patients who cannot swallow
Strict isolation of suspected patients

Question 11

Treatment for close contacts of patients with diphtheriae

Answer 11

Amoxicillin, oral, for 14 days
Or
For patients who may not tolerate penicillins:
Azithromycin, oral, for 5 days

Question 12

Regimen for diphtheriae antitoxin

Answer 12

Diphtheria antitoxin, IV infusion, (following an intradermal test dose
of 0.1 ml of 1 in 10 dilution of antitoxin in Sodium Chloride 0.9%)
Adults
10,000 to 20,000 units
Children
> 10 years; 10,000-20,000 units
< 10 years; 5,000-10,000 units

Question 13

Dose of benzylpenicillin in diphtheriae

Answer 13

Benzyl Penicillin, IV,
Adults
1.2 g 6 hourly for 48 hours
Children and Neonates
1 month-18 years; 50 mg/kg 6 hourly for 48 hours

Question 14

Dose of amoxicillin for diphtheriae

Answer 14

Amoxicillin, oral,
Adults
1 g 12 hourly for 5 days
Children
5-18 years; 500 mg 12 hourly for 10 days
1-5 years; 250 mg 12 hourly for 10 days
1 month-1 year; 125 mg 12 hourly for 10 days

Question 15

Dose of azithromycin for diphtheriae

Answer 15

Azithromycin, oral,
Adults
500 mg daily for 5 days
Children
10 mg/kg body weight daily for 5 days