A Simple guide to Diphtheria

A Simple guide to Diphtheria
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What is Diphtheria?
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Diphtheria is an acute, infectious childhood disease of the respiratory tract caused by the bacillus Corynebacterium diphtheriae, a Gram positive, non-sporulating aerobic micro-organism.

How is Diphtheria transmitted?
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Diphtheria is transmitted by droplets from the throat of infected patients or clothes soiled by discharges from the patients.
It is highly infectious.
Incubation period is 2-4 days.

The organism multiplies in the upper respiratory tract, secreting toxins which produce necrosis and fibrinous exudate.
This fibrinous exudate can form a leathery membrane which extends through the throat, tonsils, nasopharynx, larynx and trachea.
Through the blood, the toxin can spreadto the heart, nervous system and kidneys. Infections may also be localised in wounds in the skin,conjunctiva and rarely the vagina.
The infections occur in persons of all ages.

What are the Signs and Symptoms of Diphtheria?
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The incubation peroid is usually 2-4 days after contact with an infected patient.

Symptoms start off with:
1. sudden onset of malaise

2. mild fever

3. sore throat

4. Thick white or grayish tonsillar exudate

5. Membrane may spread to nasopharynx

5. cervical lymphadenopathy

6. difficult breathing

7. respiratory stridor,

8. hoarseness of voice

9. brassy cough

10.dilirium and coma

What are the complications of Diphtheria?
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The worst affected are children below the 1 year old.

Some serious complications are:
1.myocarditis

2.cranial nerve paralysis, especially the soft palate and oculomotor nerves

3.peripheral neuritis

4.laryngeal obstruction

5.death can occur if there is obstruction to breathing.

Serious complications are less with older children or adults.

Adults rarely get Diphtheria because their immunity from vaccination usually last 10 years after the last dose.
When adults get Diphtheria, there is only slight inflammation with little or no exudates.

What are the investigations necessary to diagnose Diphtheria?
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Pharyngeal and nasal swabs for culture in Loeffler medium
Methylene blue stain of membrane

What is the Treatment of Diphtheria?
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Isolation in hospital is necessary.

1.Antibiotics (erythromycin or Penicillin) are used in the treatment of Diphtheria.

2.Antitoxin can be given by intramuscular or intravenous injection

3.Intravenous fluids given for dehydration

4.Tracheostomy if breathing obstruction is bad

5.Oxygen therapy in cases of breathing difficulty

6.Cardiac failure should be treated


Besides antibiotics, the following will help:
Steam inhalation
cough mixtures
avoid smokes, dust, dry air,sudden temperature change

What is the Prevention for Diphtheria?
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Vaccination against Diphtheria is the best prevention .
Since vaccination began, the worldwide incidence of Diphtheria has declined.

Vaccination against diphtheria, pertussis (whooping cough), tetanus (DPT) is usually given to a baby at 3 months of age and repeated at 4 and 5 months of age.

There is also a booster vaccination at 18 months.

What is the prognosis in Diphtheria?
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Death occurs in 10% of cases.

Mortality is highest in children under 10 and adults over 50.

One attack usually confers immunity.