Diphtheria is a severe bacterial illness and originates from Corynebacterium diphtheriae. It mainly targets the throat and the nose. The primary manifestations are sore throat, fever, and a thick, gray, or white coating in the throat and the tonsils. These bacteria synthesize toxic enzymes into tissues and organs, which may lead to severe consequences like myocarditis, neuropathy, etc.
It is transmitted through aerosols from an infected person when an individual coughs or sneezes or by touching objects that have the disease’s virus on them. In the recent past, the diphtheria toxoid vaccine has proved to be a good preventer of the disease across the world.
Epidemiology
Global Incidence: Because of efficient vaccination, Diphtheria has become rare in many countries across the globe especially those that are considered developed. Although it is gradually being wiped out in so many countries, it remains a challenge in some developing regions.
Vaccination Impact: Because of this diphtheria vaccine which had possibility of being administered alongside with tetanus, pertussis, and other vaccines, the DTP vaccines, diphtheria incidence has reduced in societies which have embraced vaccines.
Age Groups: It affects children most of the time and even unimmunized adults also. Moreover, previous data obtained from other countries showed that children below 5 years were prone to get affected by the disease.
Anatomy
Pathophysiology
Entry and Colonization: It is usually an aspiration of the bacteria or contact with objects that contain the bacteria and then makes its home in the bacteria’s favoured sites, which are the nasopharynx or the skin.
Toxin Production: C. diphtheriae produces a toxic substance known as exotoxin which gets into the blood stream. The toxin also influences the host cell by binding to the elongation factor-2 thereby inactivating it and so disturbing the protein synthesis and causing death on the host cell.
Local and Systemic Effects: Locally, the toxin produces tissue coagulative necrosis and produces a typical grayish pseudomembrane in the throat. In a systemic sense, it may harm a various organ and may result in consequences like myocarditis and neuropathy.
Immune Response: These antibodies reduce the body’s ability to metabolize the toxin and release inflammatory substances that cause damage to tissues thus worsening the disease process.
Etiology
Diphtheria is an infectious disease produced by bacterium Corynebacterium diphtheriae. It makes a toxic substance which influences the mucous membranes of the throat and nose; it causes inflammation, membrane formation, and can cause severe systemic reactions if the patient is not treated. Transmission is closely linked with respiratory droplets exhaled by a person infected with the disease.
Genetics
Prognostic Factors
Age: Children as well as older and vulnerable individuals are among the groups of people that are at a higher risk of getting worse.
Immunization Status: Those persons who have not been administered with the vaccine or received only the first or second dose give poor results.
Severity of Disease: Factors that were established to affect prognosis include the following: respiratory or systemic involvement in those cases.
Timelines of Treatment: Therefore, there is rationale for administration of the antitoxin and antibiotics in the as soon as possible in the course of the disease.
Complications: The development of certain complications such as myocarditis or neuritis may also turn into negative indicator for prognosis.
Clinical History
Age Group:
Diphtheria can affect anyone at any time in their life but frequently attacks those in the age bracket of children. In the past it used to be most prevalent in children below the age of 5 years and this has been greatly reduced due to immunization. But now-a-days, Diphtheria in adults is not so usual but can occur, if the rate of vaccine coverage is less. It is more dangerous in the young children and vaccination plays a very vital role in the young children.
Physical Examination
Throat Examination
Pseudo membrane
Redness and Swelling
Difficulty Swallowing
Lymph Nodes:
Cervical Lymphadenopathy
General Appearance:
Fever
Malaise
Breathing:
Stridor
Respiratory Distress
Skin:
Rashes
Age group
Associated comorbidity
Myocarditis
Neuropathy
Renal Failure
Respiratory Complications
Systemic Infections
Associated activity
Acuity of presentation
Sore Throat: They include severe throat pain, especially when swallowing food and liquids.
Fever: The physical symptoms include mild to moderate fever. Lymphadenopathy: Lymphadenopathy, especially cervical, is referred to as bull neck.
Pseudo membrane: There is appearance of a grayish-white coating that develops on the tonsils covering the neck area including the pharynx or larynx.
Differential Diagnoses
Streptococcal Pharyngitis (Strep Throat)
Viral Pharyngitis
Mononucleosis
Laryngotracheobronchitis (Croup)
Candida Infection (Oral Thrush)
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
Antitoxin Therapy: Giving out diphtheria antitoxin is essential to counter act the toxin which is released by the bacteria. This is the initial therapy and should be started as soon as clinical suspicion of Diphtheria is made.
Antibiotics: Antibiotics help to eradicate the bacteria to avoid the spreading of the disease.
Commonly used antibiotics include:
Penicillin: It is usually given as intravenous.
Erythromycin: Another antibiotic erythromycin is given when the patient is allergic to the penicillin.
Supportive Care: It may cover the following:
Airway Management: For severe cases, significantly if the airway is obstructed, pseudo membrane formation, intubation / tracheostomy may be necessary.
Hydration and Nutrition: Make sure that the patient is well hydrated before carrying on with the treatment also make sure that the patient has well taken their meals.
Isolation: To avoid further transmission of Diphtheria the patient should be isolated until they no longer become infectious, this can be after 48 hours of starting on the right antibiotics.
Immunization: This disease can be spread person to person and the risk of getting the disease is reduced through post exposure administration of the diphtheria toxoid, but mass immunization is advised.
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
lifestyle-modifications-in-treating-diphtheria
Vaccination: Vaccinate multiple people within a community using the DTP (Diphtheria, tetanus, pertussis) vaccine. Children and those who have not been immunized are susceptible to developing Diphtheria and the best protection that is available is the administration of the vaccines.
Hygiene and Sanitation: Practicing excellent and proper hygiene for instance washing of hands with soap and water. Construct proper washrooms to avoid contamination by bacteria.
Isolation: Isolate the people with Diphtheria to prevent the spreading of the diseases to other people in the society. This is even more applicable where people are often bound to get grouped or population is often dense.
Antibiotic Prophylaxis: Before the signs or symptoms of Diphtheria the people who are in close contact with the infected individual are administered with antibiotics to stop the spread of the disease.
Monitoring and Reporting: It is also important to establish ways of monitoring and reporting incidences of Diphtheria to identify epidemics early enough.
Public Education: Educate people concerning the importance of immunization against the disease and how to recognize diphtheria symptoms.
Effectiveness of Diphtheria antitoxin in treating Diphtheria
Diphtheria antitoxin
In the United States, there is the existing of the facility to produce Diphtheria which is being handled by the CDC.
Preparation of antitoxin therapy helps treat Diphtheria, the moment when it’s clinically suspected after a laboratory analysis of the patient’s sample.
The antitoxin is administered intravenously.
Use of Macrolides in treating Diphtheria
Erythromycin
Antibiotics such as the Macrolides for instance erythromycin can be used to treat Diphtheria. These antibiotics are shown to be effective against Corynebacterium diphtheriae. They can be used to be preferred when penicillin cannot be used for example in situations the individual is allergic to it.
Use of Antibiotic, penicillin in treating Diphtheria
Penicillin
It assists in eradicating Corynebacterium diphtheriae, the bacteria responsible for the disease. In the conventional treatment, treatment may involve a course of penicillin or erythromycin may be necessary.
role-of-management-in-treating-diphtheria
Diagnosis and Isolation:
In the provision of such disease, appropriate identification and diagnosis are necessary; a clinical examination was performed in addition to laboratory tests.
It is essential to take some preventive measures that include isolating the patient so that the spread does not occur again.
Antitoxin Administration:
Diphtheria antitoxin should be given as soon as possible to help counteract the action of the toxin.
Antibiotic Therapy:
As for the treatment start using antibiotics like penicillin or erythromycin to eradicate the bacteria and for non-transmission of the disease to other individuals.
Supportive Care:
Ventilatory support: Build a clear understanding of techniques in managing airway obstruction and other measures such as fluid support and other analgesia.
Follow-up and Monitoring:
Check for the emergence of complications and once none is present, ascertain that the patient is cured from the infection.
Make and assess for other possible implications of the condition.
Vaccination:
As a preventive measure and to ensure the patient achieves immunity and the patient ought to be vaccinated.
Diphtheria is a severe bacterial illness and originates from Corynebacterium diphtheriae. It mainly targets the throat and the nose. The primary manifestations are sore throat, fever, and a thick, gray, or white coating in the throat and the tonsils. These bacteria synthesize toxic enzymes into tissues and organs, which may lead to severe consequences like myocarditis, neuropathy, etc.
It is transmitted through aerosols from an infected person when an individual coughs or sneezes or by touching objects that have the disease’s virus on them. In the recent past, the diphtheria toxoid vaccine has proved to be a good preventer of the disease across the world.
Global Incidence: Because of efficient vaccination, Diphtheria has become rare in many countries across the globe especially those that are considered developed. Although it is gradually being wiped out in so many countries, it remains a challenge in some developing regions.
Vaccination Impact: Because of this diphtheria vaccine which had possibility of being administered alongside with tetanus, pertussis, and other vaccines, the DTP vaccines, diphtheria incidence has reduced in societies which have embraced vaccines.
Age Groups: It affects children most of the time and even unimmunized adults also. Moreover, previous data obtained from other countries showed that children below 5 years were prone to get affected by the disease.
Entry and Colonization: It is usually an aspiration of the bacteria or contact with objects that contain the bacteria and then makes its home in the bacteria’s favoured sites, which are the nasopharynx or the skin.
Toxin Production: C. diphtheriae produces a toxic substance known as exotoxin which gets into the blood stream. The toxin also influences the host cell by binding to the elongation factor-2 thereby inactivating it and so disturbing the protein synthesis and causing death on the host cell.
Local and Systemic Effects: Locally, the toxin produces tissue coagulative necrosis and produces a typical grayish pseudomembrane in the throat. In a systemic sense, it may harm a various organ and may result in consequences like myocarditis and neuropathy.
Immune Response: These antibodies reduce the body’s ability to metabolize the toxin and release inflammatory substances that cause damage to tissues thus worsening the disease process.
Diphtheria is an infectious disease produced by bacterium Corynebacterium diphtheriae. It makes a toxic substance which influences the mucous membranes of the throat and nose; it causes inflammation, membrane formation, and can cause severe systemic reactions if the patient is not treated. Transmission is closely linked with respiratory droplets exhaled by a person infected with the disease.
Age: Children as well as older and vulnerable individuals are among the groups of people that are at a higher risk of getting worse.
Immunization Status: Those persons who have not been administered with the vaccine or received only the first or second dose give poor results.
Severity of Disease: Factors that were established to affect prognosis include the following: respiratory or systemic involvement in those cases.
Timelines of Treatment: Therefore, there is rationale for administration of the antitoxin and antibiotics in the as soon as possible in the course of the disease.
Complications: The development of certain complications such as myocarditis or neuritis may also turn into negative indicator for prognosis.
Age Group:
Diphtheria can affect anyone at any time in their life but frequently attacks those in the age bracket of children. In the past it used to be most prevalent in children below the age of 5 years and this has been greatly reduced due to immunization. But now-a-days, Diphtheria in adults is not so usual but can occur, if the rate of vaccine coverage is less. It is more dangerous in the young children and vaccination plays a very vital role in the young children.
Throat Examination
Pseudo membrane
Redness and Swelling
Difficulty Swallowing
Lymph Nodes:
Cervical Lymphadenopathy
General Appearance:
Fever
Malaise
Breathing:
Stridor
Respiratory Distress
Skin:
Rashes
Myocarditis
Neuropathy
Renal Failure
Respiratory Complications
Systemic Infections
Sore Throat: They include severe throat pain, especially when swallowing food and liquids.
Fever: The physical symptoms include mild to moderate fever. Lymphadenopathy: Lymphadenopathy, especially cervical, is referred to as bull neck.
Pseudo membrane: There is appearance of a grayish-white coating that develops on the tonsils covering the neck area including the pharynx or larynx.
Streptococcal Pharyngitis (Strep Throat)
Viral Pharyngitis
Mononucleosis
Laryngotracheobronchitis (Croup)
Candida Infection (Oral Thrush)
Antitoxin Therapy: Giving out diphtheria antitoxin is essential to counter act the toxin which is released by the bacteria. This is the initial therapy and should be started as soon as clinical suspicion of Diphtheria is made.
Antibiotics: Antibiotics help to eradicate the bacteria to avoid the spreading of the disease.
Commonly used antibiotics include:
Penicillin: It is usually given as intravenous.
Erythromycin: Another antibiotic erythromycin is given when the patient is allergic to the penicillin.
Supportive Care: It may cover the following:
Airway Management: For severe cases, significantly if the airway is obstructed, pseudo membrane formation, intubation / tracheostomy may be necessary.
Hydration and Nutrition: Make sure that the patient is well hydrated before carrying on with the treatment also make sure that the patient has well taken their meals.
Isolation: To avoid further transmission of Diphtheria the patient should be isolated until they no longer become infectious, this can be after 48 hours of starting on the right antibiotics.
Immunization: This disease can be spread person to person and the risk of getting the disease is reduced through post exposure administration of the diphtheria toxoid, but mass immunization is advised.
Emergency Medicine
Vaccination: Vaccinate multiple people within a community using the DTP (Diphtheria, tetanus, pertussis) vaccine. Children and those who have not been immunized are susceptible to developing Diphtheria and the best protection that is available is the administration of the vaccines.
Hygiene and Sanitation: Practicing excellent and proper hygiene for instance washing of hands with soap and water. Construct proper washrooms to avoid contamination by bacteria.
Isolation: Isolate the people with Diphtheria to prevent the spreading of the diseases to other people in the society. This is even more applicable where people are often bound to get grouped or population is often dense.
Antibiotic Prophylaxis: Before the signs or symptoms of Diphtheria the people who are in close contact with the infected individual are administered with antibiotics to stop the spread of the disease.
Monitoring and Reporting: It is also important to establish ways of monitoring and reporting incidences of Diphtheria to identify epidemics early enough.
Public Education: Educate people concerning the importance of immunization against the disease and how to recognize diphtheria symptoms.
Emergency Medicine
Diphtheria antitoxin
In the United States, there is the existing of the facility to produce Diphtheria which is being handled by the CDC.
Preparation of antitoxin therapy helps treat Diphtheria, the moment when it’s clinically suspected after a laboratory analysis of the patient’s sample.
The antitoxin is administered intravenously.
Emergency Medicine
Erythromycin
Antibiotics such as the Macrolides for instance erythromycin can be used to treat Diphtheria. These antibiotics are shown to be effective against Corynebacterium diphtheriae. They can be used to be preferred when penicillin cannot be used for example in situations the individual is allergic to it.
Emergency Medicine
Penicillin
It assists in eradicating Corynebacterium diphtheriae, the bacteria responsible for the disease. In the conventional treatment, treatment may involve a course of penicillin or erythromycin may be necessary.
Emergency Medicine
Diagnosis and Isolation:
In the provision of such disease, appropriate identification and diagnosis are necessary; a clinical examination was performed in addition to laboratory tests.
It is essential to take some preventive measures that include isolating the patient so that the spread does not occur again.
Antitoxin Administration:
Diphtheria antitoxin should be given as soon as possible to help counteract the action of the toxin.
Antibiotic Therapy:
As for the treatment start using antibiotics like penicillin or erythromycin to eradicate the bacteria and for non-transmission of the disease to other individuals.
Supportive Care:
Ventilatory support: Build a clear understanding of techniques in managing airway obstruction and other measures such as fluid support and other analgesia.
Follow-up and Monitoring:
Check for the emergence of complications and once none is present, ascertain that the patient is cured from the infection.
Make and assess for other possible implications of the condition.
Vaccination:
As a preventive measure and to ensure the patient achieves immunity and the patient ought to be vaccinated.
Diphtheria is a severe bacterial illness and originates from Corynebacterium diphtheriae. It mainly targets the throat and the nose. The primary manifestations are sore throat, fever, and a thick, gray, or white coating in the throat and the tonsils. These bacteria synthesize toxic enzymes into tissues and organs, which may lead to severe consequences like myocarditis, neuropathy, etc.
It is transmitted through aerosols from an infected person when an individual coughs or sneezes or by touching objects that have the disease’s virus on them. In the recent past, the diphtheria toxoid vaccine has proved to be a good preventer of the disease across the world.
Global Incidence: Because of efficient vaccination, Diphtheria has become rare in many countries across the globe especially those that are considered developed. Although it is gradually being wiped out in so many countries, it remains a challenge in some developing regions.
Vaccination Impact: Because of this diphtheria vaccine which had possibility of being administered alongside with tetanus, pertussis, and other vaccines, the DTP vaccines, diphtheria incidence has reduced in societies which have embraced vaccines.
Age Groups: It affects children most of the time and even unimmunized adults also. Moreover, previous data obtained from other countries showed that children below 5 years were prone to get affected by the disease.
Entry and Colonization: It is usually an aspiration of the bacteria or contact with objects that contain the bacteria and then makes its home in the bacteria’s favoured sites, which are the nasopharynx or the skin.
Toxin Production: C. diphtheriae produces a toxic substance known as exotoxin which gets into the blood stream. The toxin also influences the host cell by binding to the elongation factor-2 thereby inactivating it and so disturbing the protein synthesis and causing death on the host cell.
Local and Systemic Effects: Locally, the toxin produces tissue coagulative necrosis and produces a typical grayish pseudomembrane in the throat. In a systemic sense, it may harm a various organ and may result in consequences like myocarditis and neuropathy.
Immune Response: These antibodies reduce the body’s ability to metabolize the toxin and release inflammatory substances that cause damage to tissues thus worsening the disease process.
Diphtheria is an infectious disease produced by bacterium Corynebacterium diphtheriae. It makes a toxic substance which influences the mucous membranes of the throat and nose; it causes inflammation, membrane formation, and can cause severe systemic reactions if the patient is not treated. Transmission is closely linked with respiratory droplets exhaled by a person infected with the disease.
Age: Children as well as older and vulnerable individuals are among the groups of people that are at a higher risk of getting worse.
Immunization Status: Those persons who have not been administered with the vaccine or received only the first or second dose give poor results.
Severity of Disease: Factors that were established to affect prognosis include the following: respiratory or systemic involvement in those cases.
Timelines of Treatment: Therefore, there is rationale for administration of the antitoxin and antibiotics in the as soon as possible in the course of the disease.
Complications: The development of certain complications such as myocarditis or neuritis may also turn into negative indicator for prognosis.
Age Group:
Diphtheria can affect anyone at any time in their life but frequently attacks those in the age bracket of children. In the past it used to be most prevalent in children below the age of 5 years and this has been greatly reduced due to immunization. But now-a-days, Diphtheria in adults is not so usual but can occur, if the rate of vaccine coverage is less. It is more dangerous in the young children and vaccination plays a very vital role in the young children.
Throat Examination
Pseudo membrane
Redness and Swelling
Difficulty Swallowing
Lymph Nodes:
Cervical Lymphadenopathy
General Appearance:
Fever
Malaise
Breathing:
Stridor
Respiratory Distress
Skin:
Rashes
Myocarditis
Neuropathy
Renal Failure
Respiratory Complications
Systemic Infections
Sore Throat: They include severe throat pain, especially when swallowing food and liquids.
Fever: The physical symptoms include mild to moderate fever. Lymphadenopathy: Lymphadenopathy, especially cervical, is referred to as bull neck.
Pseudo membrane: There is appearance of a grayish-white coating that develops on the tonsils covering the neck area including the pharynx or larynx.
Streptococcal Pharyngitis (Strep Throat)
Viral Pharyngitis
Mononucleosis
Laryngotracheobronchitis (Croup)
Candida Infection (Oral Thrush)
Antitoxin Therapy: Giving out diphtheria antitoxin is essential to counter act the toxin which is released by the bacteria. This is the initial therapy and should be started as soon as clinical suspicion of Diphtheria is made.
Antibiotics: Antibiotics help to eradicate the bacteria to avoid the spreading of the disease.
Commonly used antibiotics include:
Penicillin: It is usually given as intravenous.
Erythromycin: Another antibiotic erythromycin is given when the patient is allergic to the penicillin.
Supportive Care: It may cover the following:
Airway Management: For severe cases, significantly if the airway is obstructed, pseudo membrane formation, intubation / tracheostomy may be necessary.
Hydration and Nutrition: Make sure that the patient is well hydrated before carrying on with the treatment also make sure that the patient has well taken their meals.
Isolation: To avoid further transmission of Diphtheria the patient should be isolated until they no longer become infectious, this can be after 48 hours of starting on the right antibiotics.
Immunization: This disease can be spread person to person and the risk of getting the disease is reduced through post exposure administration of the diphtheria toxoid, but mass immunization is advised.
Emergency Medicine
Vaccination: Vaccinate multiple people within a community using the DTP (Diphtheria, tetanus, pertussis) vaccine. Children and those who have not been immunized are susceptible to developing Diphtheria and the best protection that is available is the administration of the vaccines.
Hygiene and Sanitation: Practicing excellent and proper hygiene for instance washing of hands with soap and water. Construct proper washrooms to avoid contamination by bacteria.
Isolation: Isolate the people with Diphtheria to prevent the spreading of the diseases to other people in the society. This is even more applicable where people are often bound to get grouped or population is often dense.
Antibiotic Prophylaxis: Before the signs or symptoms of Diphtheria the people who are in close contact with the infected individual are administered with antibiotics to stop the spread of the disease.
Monitoring and Reporting: It is also important to establish ways of monitoring and reporting incidences of Diphtheria to identify epidemics early enough.
Public Education: Educate people concerning the importance of immunization against the disease and how to recognize diphtheria symptoms.
Emergency Medicine
Diphtheria antitoxin
In the United States, there is the existing of the facility to produce Diphtheria which is being handled by the CDC.
Preparation of antitoxin therapy helps treat Diphtheria, the moment when it’s clinically suspected after a laboratory analysis of the patient’s sample.
The antitoxin is administered intravenously.
Emergency Medicine
Erythromycin
Antibiotics such as the Macrolides for instance erythromycin can be used to treat Diphtheria. These antibiotics are shown to be effective against Corynebacterium diphtheriae. They can be used to be preferred when penicillin cannot be used for example in situations the individual is allergic to it.
Emergency Medicine
Penicillin
It assists in eradicating Corynebacterium diphtheriae, the bacteria responsible for the disease. In the conventional treatment, treatment may involve a course of penicillin or erythromycin may be necessary.
Emergency Medicine
Diagnosis and Isolation:
In the provision of such disease, appropriate identification and diagnosis are necessary; a clinical examination was performed in addition to laboratory tests.
It is essential to take some preventive measures that include isolating the patient so that the spread does not occur again.
Antitoxin Administration:
Diphtheria antitoxin should be given as soon as possible to help counteract the action of the toxin.
Antibiotic Therapy:
As for the treatment start using antibiotics like penicillin or erythromycin to eradicate the bacteria and for non-transmission of the disease to other individuals.
Supportive Care:
Ventilatory support: Build a clear understanding of techniques in managing airway obstruction and other measures such as fluid support and other analgesia.
Follow-up and Monitoring:
Check for the emergence of complications and once none is present, ascertain that the patient is cured from the infection.
Make and assess for other possible implications of the condition.
Vaccination:
As a preventive measure and to ensure the patient achieves immunity and the patient ought to be vaccinated.
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