Diphtheria
Respiratory diphtheria; Pharyngeal diphtheria; Diphtheric cardiomyopathy; Diphtheric polyneuropathyDiphtheria is an acute infection caused by the bacterium Corynebacterium diphtheriae.
Acute
Acute means sudden. Acute symptoms appear, change, or worsen rapidly. It is the opposite of chronic.
Read Article Now Book Mark ArticleCauses
The bacteria that cause diphtheria spread through respiratory droplets (such as from a cough or sneeze) of an infected person or someone who carries the bacteria but has no symptoms.
The bacteria most commonly infect your nose and throat. The throat infection causes a gray to black, tough, fiber-like covering, which can block your airways. In some cases, diphtheria infects your skin first and causes skin lesions.
Skin lesions
Rashes involve changes in the color, feeling or texture of your skin.
Read Article Now Book Mark ArticleOnce you are infected, the bacteria make dangerous substances called toxins. The toxins spread through your bloodstream to other organs, such as the heart and brain, and cause damage.
Because of widespread vaccination (immunization) of children, diphtheria is now rare in many parts of the world.
Risk factors for diphtheria include crowded environments, poor hygiene, and lack of immunization.
Symptoms
Symptoms usually occur 2 to 5 days after the bacteria enter your body:
- Fever and chills
- Sore throat, hoarseness
Hoarseness
Hoarseness refers to difficulty making sounds when trying to speak. Vocal sounds may be weak, breathy, scratchy, or husky, and the pitch or quality ...
Read Article Now Book Mark Article - Painful swallowing
- Croup-like (barking) cough
- Drooling (suggests airway blockage is about to occur)
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Bluish coloration of the skin
Bluish coloration of the skin
A bluish color to the skin or mucous membrane is usually due to a lack of oxygen in the blood. The medical term is cyanosis.
Read Article Now Book Mark Article - Bloody, watery drainage from nose
- Breathing problems, including difficulty breathing, fast breathing, high-pitched breathing sound (stridor)
Stridor
Stridor is an abnormal, high-pitched, musical breathing sound. It is caused by a blockage in the throat or voice box (larynx). It is most often hea...
Read Article Now Book Mark Article - Skin sores (usually seen in tropical areas)
Sometimes there are no symptoms.
Exams and Tests
Your health care provider will perform a physical exam and look inside your mouth. This may reveal a gray to black covering (pseudomembrane) in the throat, enlarged lymph glands, and swelling of the neck or vocal cords.
Enlarged lymph glands
Lymph nodes are present throughout your body. They are an important part of your immune system. Lymph nodes help your body recognize and fight germ...
Read Article Now Book Mark ArticleTests used may include:
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Gram stain or throat culture to identify the diphtheria bacteria
Gram stain
A Gram stain is a test used to identify bacteria. It is one of the most common ways to quickly diagnose bacterial infection in the body.
Read Article Now Book Mark ArticleThroat culture
A throat swab culture is a laboratory test that is done to identify germs that may cause infection in the throat. It is most often used to diagnose ...
Read Article Now Book Mark Article - Toxin assay (to detect the presence of the toxin made by the bacteria)
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Electrocardiogram (ECG)
Electrocardiogram
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
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Treatment
If your provider thinks you have diphtheria, treatment will likely be started right away, even before test results come back.
Diphtheria antitoxin is given as a shot into a muscle or through an IV (intravenous line). The infection is then treated with antibiotics, such as penicillin and erythromycin.
Intravenous
Intravenous means "within a vein. " Most often it refers to giving medicines or fluids through a needle or tube inserted into a vein. This allows th...
Read Article Now Book Mark ArticleYou may need to stay in the hospital while getting the antitoxin. Other treatments may include:
- Fluids by IV
- Oxygen
- Bed rest
- Heart monitoring
- Insertion of a breathing tube
- Correction of airway blockages
People without symptoms who carry diphtheria should be treated with antibiotics.
Outlook (Prognosis)
Diphtheria may be mild or severe. Some people do not have symptoms. In others, the disease can slowly get worse. Recovery from the illness is slow.
People may die, especially when the disease affects the heart.
Possible Complications
The most common complication is inflammation of the heart muscle (myocarditis). The nervous system is also frequently and severely affected, which may result in temporary paralysis.
Myocarditis
Myocarditis is inflammation of the heart muscle. The condition is called pediatric myocarditis when it occurs in children.
Read Article Now Book Mark ArticleParalysis
Muscle function loss is when a muscle does not work or move normally. The medical term for complete loss of muscle function is paralysis.
Read Article Now Book Mark ArticleThe diphtheria toxin can also damage the kidneys.
There can also be an allergic response to the antitoxin.
When to Contact a Medical Professional
Contact your provider right away if you have come in contact with a person who has diphtheria.
Diphtheria is a rare disease. It is also a reportable disease, and any cases are often publicized in the media. This helps you to know if diphtheria is present in your area.
Reportable disease
Reportable diseases are diseases considered to be of great public health importance. In the United States, local, state, and national agencies (for ...
Read Article Now Book Mark ArticlePrevention
Routine childhood immunizations and adult boosters prevent the disease.
Anyone who has come into contact with an infected person should get an immunization or booster shot against diphtheria, if they have not already received it. Protection from the vaccine lasts only 10 years. So it is important for adults to get a booster vaccine every 10 years. The booster is called tetanus-diphtheria (Td). (The shot also has vaccine medicine for an infection called tetanus.)
Immunization
All content below is taken in its entirety from the Centers for Disease Control and Prevention (CDC) DTaP vaccine information statement (VIS) -- www....
Read Article Now Book Mark ArticleTd
All content below is taken in its entirety from the Centers for Disease Control and Prevention (CDC) Td vaccine information statement (VIS) -- www. c...
Read Article Now Book Mark ArticleTetanus
Tetanus is an infection of the nervous system with a type of bacteria that is potentially deadly, called Clostridium tetani (C tetani).
Read Article Now Book Mark ArticleIf you have been in close contact with a person who has diphtheria, contact your provider right away. Ask whether you need antibiotics to prevent getting diphtheria.
References
Centers for Disease Control and Prevention website. Diphtheria. www.cdc.gov/diphtheria/about/index.html. Updated September 9, 2022. Accessed March 14, 2024.
Saleeb PG. Corynebacterium diphtheriae (diphtheria). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 204.
Stechenberg BW. Diphtheria. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 90.
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Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
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Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
Review Date: 12/31/2023
Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.