DIPHTHERIA

It is an acute infection caused by Gram positive bacillus, Corynebacterium Diphtheriae.
It spreads by droplet infection.
Incubation period : 2-6 days

Incidence :
The incidence has fallen markedly in the last quarter of a century.
Children are particularly affected , especially those between 2-5 years of age. But any age group can be affected.

Because of widespread and routine childhood DPT immunizations, diphtheria is now rare in many parts of the world.
Risk factors include crowded environments, poor hygiene, and lack of immunization.

Symptoms :
Sore throat
Painful swallowing
Neck swelling
Low grade fever, headache, malaise
Vomiting
Sign :
Enlarged and tender cervical lymph nodes.
Sometimes presenting a “bull-neck” appearance.
Patches of false membrane are present on the tonsils, faucial pillars, soft palate and occasionally on the posterior pharyngeal pharyngeal wall. It is usually grey in colour. It is firmly attached and when detached, leaves a bleeding surface on which it tends to re-form. It often has a strong foetor. In atypical cases no false membrane is present and picture resembles a simple streptococcal infection.
Pyrexia : The temperature is rarely above 38.30C(1010F), but the pulse rate is usually raised out of proportion.
Toxaemia is marked.( Patient is ill and toxic but fever seldom rises above 380C)

Complications :
Myocarditis
Cardiac arrythmia
Acute circulatory failure
Paralysis of soft palate, diaphragm and ocular muscles.
Laryngeal diphtheria may cause airway obstruction.

Treatment :
Antitoxin must be given  immediately, without waiting for the bacteriological results of a swab, when the disease is suspected. 20,000 – 100,000 units are injected.
Systemic penicillin : helps to control the primary and any secondary infection.

Other treatments may include:

Fluids by IV
Oxygen
Bed rest
Heart monitoring
Insertion of a breathing tube
Correction of airway blockages