Diphtheria is a bacterial infection of the upper respiratory tract caused by Corynebacterium diphtheriae. Though largely eradicated from most countries around the world, the disease continues to erupt in certain less developed pockets of the world. Nonetheless, it has still made recent appearances in countries such as the United States and Germany. Diphtheria is prevented thanks to the development of an effective vaccine – the same vaccine that prevents against conditions such as pertussis and tetanus. The disease carries a significant risk of death – up to 7-9% – and this risk increases in those younger than 15 or older than 40.
One of the most characteristic symptoms of diphtheria is the presence of a gray membrane that surrounds the tonsils. This membrane can make it difficult for the patient to breathe or swallow and, as a result, the condition is often accompanied by these symptoms. In addition, patients will typically experience a significant fever, sore throat, fatigue, and enlarged lymph nodes. Diphtheria infection is also noted for the production of an enlarged neck in infected patients, often referred to as a “bull neck”. In a small minority of patients, they will continue to experience more serious symptoms such as myocarditis and peripheral neuropathy.
- Gray membrane surrounding the tonsils
- Difficulty breathing
- Difficulty swallowing
- Sore throat
- Enlarged lymph nodes
- Bull neck
The bacterium that causes Diphtheria is Corynebacterium diphtheriae. This bacterium tends to find fertile ground on the membranes at the back of the throat. Here, it will reproduce anaerobically – meaning without the need for any oxygen. This factor is important as many treatment options are designed to bear this feeding process in mind. The infection is chiefly spread via airborne means, as one breathes in the particles of an infected individual. However, one can also catch Diphtheria through contaminated objects as it latches onto many materials, such as cloth or handles. Untreated individuals still have the potential to infect non-vaccinated individuals for up to seven weeks post-infection.
- Corynebacterium diphtheriae
There are numerous means by which one can detect the presence of Diphtheria.
- Observation: Presence of gray layer covering the tonsils, while accompanied by fever, fatigue, and enlarged lymph glands.
- Histology: Taking a swab of the infection and determining the causative organism through laboratory testing.
If the patient presents with an infected wound – which is typical of Diphtheria that infects the skin – a similar swab can be taken to determine if the organism of C. diphtheriae or not. In most cases, however, such testing will not be required as the symptoms outlined above are distinct and characteristic for this particular infection.
Much of the treatment for Diphtheria is supportive, with the aim of reducing fever, inflammation, and pain. However, other medications will be required. Antibiotics such as erythromycin and penicillin are wholly recommended by the Center for Disease and Control in the management of Diphtheria. If the patient is allergic to penicillin, alternatives such as clindamycin will be considered. In many cases, an antitoxin will also be administered. However, it must first be established the patient does not have an allergy against the antitoxin. Once this safety is established, the antitoxin can be administered in order to deplete the level of existing bacteria in the body.