1
Fifth stage
Pediatric
Lec. 5
.د
رياض
1/3/2017
Diphtheria
Definition
• It is a serious bacterial infection caused by Corynebacterium Diphtheriae spread by
airborne from droplets of sneezing and cough or by direct contact from the lesion
of skin.it mainly infect the throat and cause white to gray membrane on the tonsil or
the palate and pharynx . Incubation period about 7 days . main cause of the illness is
due to toxins produced by the bacteria which once fix to the tissue, cannot be
removed with treatment.
• Mortality rate reaches 5% and increase if not treated early.
Clinical features
• Fever and chills.
• Sore throat and pain on swallowing.
• Swelling of the neck (bull neck).
• Cervical lymphadenitis.
• True croup; stridor, brassy cough, hoarseness of voice,and may need intubation or
tracheostomy for respiratory difficulty.
• If not treated early may leads to cardiac toxicity and carditis and arrhythmia.and
kidney problems.
• Palatal paralysis and other cranial nerve paralysis or peripheral nerve paralysis
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Laboratory investigations
Diagnosis depend upon the clinical suggestion followed by confirmation by lab tests.
Diagnostic test is to take swab from the throat and isolation of m.o by gram stain or
by culture of the bacteria from the swab.
Prevention
• Infection does not leads to permanent immunity and vaccine DTaP or dTaP give 10
yrs protective immunity from diphthria.
• For contact give booster by DTaP for age <6 yr.
• and dT vaccine booster for age above 6 yr
TREATMENT
• PENICILLIN G injections for 14 days or erythromycin oral for 14 days .
• Antitoxin should be given to inactivate toxins that still not combine with tissue yet.
given IM or IV injection.