Diphtheria (diphtheria)

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Diphtheria is an acute infectious disease caused by a bacterium called diphtheria urethra. This bacterium enters the body through the nose or mouth and colonizes the mucous membranes of the upper respiratory tract. It happens that it involves the conjunctiva, middle ear and mucous membranes of the genital organs.

What is diphtheria?

Diphtheria, or diphtheria, is an infectious disease caused by diphtheria urethra bacteria. The disease is severe and can even result in death. We become infected with diphtheria through airborne droplets and through direct contact with a sick person or carrier. When the bacterium enters the patient’s body through the nose or mouth, it occupies the mucous membranes of the upper respiratory tract. Occasionally, the conjunctiva, middle ear, genital mucosa, or wounded skin may be affected. The bacterium produces a toxin that penetrates through damaged mucous membranes and getting into the bloodstream can damage many internal organs, such as: kidneys, adrenal glands, heart, liver and central nervous system.

If not properly treated, the disease can cause permanent damage and even death. The local action of the toxin causes gray raids adhering to the substrate – pseudo-membranes (hence the name diphtheria). Trying to remove these membranes causes bleeding. Diphtheria is spread by droplets, less frequently through wounds, and exceptionally through food. The source of the infection is the sick person, convalescent or carrier.

Diphtheria incubation period: 2–5 days.

The causes of diphtheria

The main causes of diphtheria are the above-mentioned coryneform bacteria, while the direct stimulus that causes the disease is diphtheria toxin (venom produced by certain strains of said bacteria). The disease is spread by airborne droplets. Anyone can be a carrier of diphtheria, even healthy people have diphtheria germs in their bodies. The time it takes to catch diphtheria is approximately four weeks.

The most common types of diphtheria are:

1. pharyngeal diphtheria;
2. nasal diphtheria;
3. laryngeal diphtheria;
4. toxic diphtheria;
5. malignant diphtheria;
6. fulminant diphtheria.

Clinical forms of diphtheria and symptoms

1. Pharyngeal diphtheria

This form of diphtheria is the most common type; is manifested by the appearance of focal raids on the tonsils with a tendency to confluence or, more often, to the palatine arches, the uvula and the back of the pharynx. Body temperature rises significantly. The submandibular and cervical lymph nodes are enlarged and there is a sweetish odor in the mouth. The pale skin, dark circles under the eyes and the suffering expression on the face of the sick child draw attention. In the course of the disease, anorexia, apathy, vomiting and abdominal pain may occur.

2. Diphtheria of the nose

It mainly occurs in infants. Due to the possibility of spreading microorganisms, diphtheria is a greater threat to people in our environment than to the patient. Initially, there is a runny or purulent runny nose, then discolored with bloody discharge. There is also a wheezing and difficulty sucking.

3. Diphtheria of the larynx (angina, croup)

It develops very quickly (1-2 days), if ignored, it can lead to suffocation (a consequence of narrowing of the glottis due to the membranes that are formed). In severe cases, membranes can also occur below the larynx throughout the bronchial tree.

Symptoms: the characteristic is hoarseness up to complete aphonia, barking cough, shortness of breath, inspiratory wheeze, cyanosis. The child appears restless and scared due to severe and life-threatening hypoxia. The prognosis for this form of the disease is very serious if hospital treatment is not undertaken immediately.

4. Toxic, malignant and fulminant diphtheria

Regardless of its initial location, any case of diphtheria may initially be a toxic form or develop secondary from a non-toxic form. In the most toxic, malignant form of diphtheria, the initial stage of angina does not have to appear, and very extensive brownish deposits (due to the admixture of blood) form at once. Guttural whistling is heard, speech impairment occurs. There is a sick smell from the mouth. There is pale skin, bleeding from the nose, throat and gastrointestinal tract, severe swelling of the cervical lymph nodes (the so-called Caesar’s or Nero’s neck).

Symptoms: general symptoms include weakness, shortness of breath, increased body temperature, disturbances in heart rhythm, vision, swallowing, paralysis of the limbs. There have been a large number of deaths in toxic diphtheria.

Complications: myocarditis, neurological complications.

Treatment: antibiotic therapy, antipyretics, bed rest.

General characteristic symptoms of diphtheria

The most common characteristic symptoms that accompany diphtheria are:

1. sore throat,
2. high fever,
3. high heart rate
4. laryngeal dysfunction;
5. white almond bloom;
6. bad heart work;
7. bad breath;
8. enlarged lymph nodes;
9. changes in the nasopharynx;
10. paleness;
11. low blood pressure.

Diphtheria – treatment

Treatment of diphtheria is quite complicated. First, remove all sources of infection and, of course, isolate the sick person so that they do not infect other people. Diagnosis of diphtheria is performed by a laboratory test in which a throat swab is taken to detect the presence of corynebral diphtheria in the affected areas. The isolation of the patient from the environment may be interrupted when the presence of bacteria is not confirmed in the samples taken from the patient’s nose and throat within 6 days.

In the treatment of diphtheria, the most common antibiotic therapy is penicillin. Penicillin, thanks to its properties, destroys the bacteria that spread in the throat and on the skin. Unfortunately, this antibiotic cannot prevent the effects of the toxins produced by the bacteria – coryneform bacteria. Patients are given antitoxins to prevent the demyelination process, which in turn disrupts the functioning of the nervous system.

When caring for a child with diphtheria, be sure to give cool drinks, or even cold drinks, because they reduce throat congestion. There is no need to follow any diet during the disease, but you cannot force your child to eat when he or she has no appetite and is not hungry. It is important to maintain personal hygiene, bathe and wash your baby as usual.

Diphtheria – complications and prevention

In adults, complications of diphtheria mainly affect the heart and respiratory system. It is important that patients should refrain from exercise during treatment. Doctors recommend that you do not return to your normal lifestyle too quickly.

A vaccine is used to prevent the disease. Di-Per-Te that is given to children. It is intended to prevent diphtheria, tetanus and whooping cough. In developed countries, administration of this type of vaccine is a routine activity. According to the vaccination schedule, children should receive 4 doses of DTP vaccine before starting school and one dose of TD vaccine at 14 and 19 years of age. Adults, on the other hand, should get vaccinated every 10 years. In recent years, an epidemic of diphtheria has been observed across our eastern border. In Poland, the disease affects isolated cases. Many mothers ignore the obligation to vaccinate their children and, as a consequence, become infected because the child has not yet undergone the primary vaccination course.

In Poland, vaccinations against diphtheria are compulsory!

A patient diagnosed with diphtheria should be immediately taken to hospital for antibiotics and antitoxins. If the airway is blocked, the doctor will perform a tracheotomy to allow the patient to breathe.

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