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Friday, 6 July 2018

Diphtheria Disease: Symptoms, complications, Treatment

What Is Diphtheria?

It is an infectious disease known for a very long time, caused by the bacterium Corynebacterium diphtheria (Loffler's bacillus).
It most often affects the oropharynx, but usually affects the larynx, bronchi, skin and other organs. Airborne droplets transmit infection from a sick person to a healthy one. The possible contact-household way of transmission of the disease, especially in hot countries, where skin manifestations are frequent.
The severity of the course of it is due to the extremely toxic toxin that the diphtheria bacillus secretes. It is the diphtheria toxin, which affects the nervous, cardiovascular and excretory systems, represents the main danger to health and life. If it affects the oropharynx, then in addition to severe intoxication, the development of croup - suffocation, developing with obstruction of the respiratory tract due to developing edema and mechanical obstruction (blockage) by their film is possible. Modern medicine distinguishes several types. This is the disease of the nose, eyes, throat, larynx, skin, wound, and also genital organs. There are times when this infectious disease seizes several areas of the human body. The most dangerous to others are people suffering from this disease of throat, nose, and throat,


The devastating epidemics, whose victims are mainly children, are described in many countries throughout history. In countries with low vaccination coverage, it remains a significant health concern for children. Where immunization coverage is high, and the natural booster effect is negligible (as is the case in most industrialized countries), a significant proportion of the adult population gradually becomes susceptible as a result of decreased immunity.


The most common form of diphtheria (90-95% of all cases) is oropharyngeal diphtheria. With a localized way, the plaque is formed only on the tonsils. Symptoms of diphtheria are expressed in the form of mild intoxication, temperatures up to 38-39 0 C, headache, malaise, minor pain during swallowing. The most typical way of diphtheria, in which the film with delineated edges covers the whole almond, is difficult to remove with a spatula; when trying to remove it, the surface of the tonsil bleeds; the film is dense; lymph nodes are not very painful, mobile.


Dangerous complications determine the severity. The toxin can cause an infectious-toxic shock (a complex pathological shift in the activity of all vital body systems), myocarditis (inflammation of the heart muscle), multiple lesions of nerve trunks, inflammation and dystrophy of the renal tubules, etc.
More often it proceeds with complication in the form of paralysis of the soft palate, vocal cords, neck muscles, respiratory tracts, and extremities. Because of disease of the respiratory tract, asphyxia (with croup) may occur, provoking a fatal outcome.

With a localized form, throat complications occur in 5-20% of cases; with more severe forms of the disease, the percentage of complications develops significantly. The more complex the clinical way, the faster the difficulties appear in the patient.

Earlier, the heart suffers: at the end of the 1st - at the second week of the disease, there is myocarditis (inflammation of the heart muscle), which is the most frequent cause of death. Inflammation of the kidneys occurs in the acutest period of the disease. The nervous system is affected both in clinical manifestations and after 2-3 months after recovery
A typical complication is peripheral paralyzes; they can be early and late. Early paralysis appears in the acute period of the disease; mainly cranial nerves are involved in the process. At the same time, the voice becomes nasal, the patient chokes while eating, liquid food pours out through the nose, the palatal curtain hangs immovable. In case of paralysis of accommodation, the patient cannot distinguish between small objects at a close distance, read, becomes far-sighted. Possible strabismus, ptosis, the disease of the facial nerve.

Before the production of anti-diphtheria antitoxic serum, the lethality reached 50-60%. After the appearance of antitoxic serum, a progressive decrease in lethality began: 20% in adults and 10% in children. Following the introduction of active immunization, the incidence rate began to decline rapidly, diphtheria in the mortality of the child population almost ceased to play a role.
Diphtheria is treated only in a hospital. Hospitalization is mandatory for patients with suspected diphtheria and bacterial carriers. Antibiotics (penicillin or erythromycin) do not affect exotoxin-induced lesions, but they limit the further growth of bacteria and the duration of the carrier of diphtheria, which often continues even after clinical recovery. The main thing in the treatment of all forms of diphtheria (except bacterial transport) is the introduction of antitoxic ant diphtheria serum (PDS), which suppresses diphtheria toxin. The severity of the disease determines the dose of anti-diphtheria serum. If you suspect a localized form, you can delay the introduction of plasma until the diagnosis is clarified. If the doctor suspects the toxic form,

Unfortunately, this disease does not always create protective immunity. Therefore, people recovering from it in the process of correction should complete active immunization with diphtheria toxoid.


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