Related articles: Diphtheria
Definition
Diphtheria is an acute, highly contagious infectious disease caused by a gram-negative bacterium called Corynebacterium diphtheriae .
Depending on the bacterial strain in question, diphtheria can affect the nasopharynx (respiratory diphtheria) or the skin. Furthermore, some C. diphtheriae strains, once they enter our body, produce a toxin capable of causing inflammation and necrosis of local tissues and organs, including the heart, nerves and kidneys.
Diphtheria is transmitted by direct contact with an infected person (respiratory droplets, contact with nose-pharyngeal secretions or infected skin lesions) or by contact with contaminated objects.
Most common symptoms and signs *
- Lowering of the voice
- Aphonia
- Anorexia
- Anuria
- Arrhythmia
- Asthenia
- Chills
- Dysphagia
- Dysphonia
- Dyspnoea
- Edema
- Erythema
- Pharyngitis
- Temperature
- Tingling in the legs
- Hypotension
- Swollen lips
- Swollen lymph nodes
- Sore throat
- Headache
- Mass or swelling in the neck
- Nausea
- odynophagia
- oliguria
- Paralysis of the vocal cords
- Throat Plates
- Proteinuria
- Cold
- Hoarseness
- Acid regurgitation
- rhinorrhoea
- Blood in the urine
- Sense of suffocation
- Squeal
- Tachycardia
- Cough
- Skin Ulcers
- Nasal voice
- He retched
Further indications
The symptoms of diphtheria vary depending on the site of infection and the infectious strain (ie whether the latter is or is not toxic).
After an incubation period of 2-7 days, oropharyngeal infections occur with sore throat, loss of appetite, low-grade fever and irritation of the external nostrils and upper lip.
If a toxin producing strain is involved, on the other hand, within 2-3 days, patients develop characteristic grayish pseudomembranous plaques (diphtheria membranes) with inflamed, fibrinous and adherent margins on the surface of the tonsils and throat. Local edema can cause visible swelling of the neck (bull neck), hoarseness, stridor and dyspnea. Furthermore, tachycardia, nausea, vomiting, chills, headache and obstruction of the respiratory tract (due to the separation of the diphtheria membrane) are possible.
The skin form of diphtheria, on the other hand, causes skin lesions of varying appearance. Some patients experience skin ulcers that cause pain, erythema and exudate; others show gangrenous manifestations.
Diphtheria usually has a benign course, but in some cases cardiac and neurological complications may occur. Ventricular arrhythmias with a risk of complete cardiac arrest, myocarditis and heart failure may occur at cardiac level. The toxic effects on the nervous system, on the other hand, produce loss of ocular accommodation, palatal paralysis, dysphagia, reflux in the nasal cavities during swallowing and peripheral neuropathy (both motor and sensory).
The diagnosis of diphtheria is based on clinical examination and is confirmed by culture tests with Gram stain for bacterium research. The differential diagnosis is made with respect to bacterial and viral pharyngitis, infectious mononucleosis, oral syphilis and candidiasis.
The therapy involves the administration of antidifteric serum (neutralizes diphtheria toxins still circulating in the body) and antibiotics, such as penicillin or erythromycin. The prevention of diphtheria is based on vaccination with the trivalent vaccine against diphtheria, tetanus and pertussis (DTP). For this reason, diphtheria is now rare in developed countries. In Italy, vaccination coverage exceeds 95% and since 1996 no cases of diphtheria have been recorded.
