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                       A36.9 Diphtheria unspecified

Diphtheria is an acute toxin-mediated systemic disease caused by the bacterium Corynebacterium diphtheriae. Infection remains localised to the throat or skin but disease is mainly due to local inflammation and/or systemic toxaemia. Pharyngeal diphtheria presents with a membranous inflammation of the upper respiratory tract, which may be extensive enough to cause laryngeal obstruction. Damage to other organs including the myocardium, nervous system and kidneys, caused by the organism’s exotoxin, may complicate pharyngeal or cutaneous diphtheria.43Non-toxigenic C. diphtheriae usually causes mild throat or skin infection, which is occasionally complicated by invasive disease including endocarditis or arthritis. Corynebacterium ulcerans, a bacterium found in cattle and more recently in cats, can also express diphtheria toxin and cause a zoonotic infection in humans that is similar to diphtheria

C diphtheriae is commensal in the skin and nasopharynx, but toxin producing strains are pathogenic to humans causing diphtheria; both an antitoxin and vaccine are available for disease prevention.Some strains of this bacterium produce a toxin, and it is this toxin that causes the most serious complications of diphtheria. The bacteria produce a toxin because they themselves are infected by a certain type of virus called a phage.

Vaccination. Keeping up to date with recommended vaccines is the best way to prevent diphtheria. In the United States, there are four vaccines used to prevent diphtheria: DTaP, Tdap, DT, and Td. Each of these vaccines prevents diphtheria and tetanus; DTaP and Tdap also help prevent pertussis (whooping cough)

Diphtheria is a contagious and potentially life-threatening infection caused by a toxin (poison) made by bacteria. Cases of diphtheria are rare in Australia due to the introduction of an effective vaccine, but a century ago diphtheria was the most common infectious cause of death. Outbreaks still occur in countries with low vaccination rates.

There are four different types of diphtheria:

• classical respiratory diphtheria
• laryngeal diphtheria
• nasal diphtheria and
• cutaneous diphtheria (skin lesions).

Respiratory and cutaneous diphtheria are caused by toxic strains of the bacteria Corynebacterium diphtheriae and Corynebacterium ulcerans and very rarely Corynebacterium pseudotuberculosis. These toxins can lead to serious complications such as paralysis and heart failure.

Signs and Symptoms: 

Symptoms usually begin two to five days after exposure to the bacteria but sometimes appear up to 10 days after exposure. Symptoms will depend on the type of diphtheria infection.

With respiratory diphtheria a person can experience a sore throat, fever, enlarged lymph nodes and swelling of the soft tissues on both sides of the neck sometimes referred to as a ‘bull neck’. Within two or three days a membrane (a white or grey film) forms over the throat and tonsils that can make it difficult for the person to swallow and breathe.

Laryngeal diphtheria affects the voice-box. It most commonly occurs in children and is characterised by gradually increasing hoarseness and stridor (noisy breathing).

Nasal diphtheria is usually a mild but chronic illness. It is characterised by a nasal discharge which starts out clear but later becomes blood-stained.

Cutaneous diphtheria affects the skin, and usually appears as small ulcers on exposed limbs, particularly the legs.

Treatment: 

Depending on the severity of symptoms, a person with diphtheria may need to be admitted to hospital for appropriate care and treatment with antibiotics. After completing a course of antibiotics, the person will then undergo further testing to ensure that the antibiotics have been effective in clearing the bacteria, and that they are no longer infectious. For confirmed or highly probable cases of respiratory diphtheria, diphtheria antitoxin (DAT) can be given in a hospital setting to reduce the likelihood of serious complications.

Respiratory and cutaneous diphtheria are caused by toxic strains of the bacteria Corynebacterium diphtheriae and Corynebacterium ulcerans and very rarely Corynebacterium pseudotuberculosis.
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Diphtheria

• classical respiratory diphtheria.
• laryngeal diphtheria.
• nasal diphtheria and.
• cutaneous diphtheria (skin lesions).

Diphtheria is a serious infection caused by strains of bacteria called Corynebacterium diphtheriae that make a toxin (poison). It is the toxin that can cause people to get very sick. Diphtheria bacteria spread from person to person, usually through respiratory droplets, like from coughing or sneezing.

Diphtheria (from Greek: διφθέρα diphthera, meaning leather) is an infection cause by the bacterium Corynebacterium diphtheriae. Signs and symptoms may vary fro mild to severe. They usually start two to five days after exposure. Symptoms often come on fairly gradually beginning with a sore throat and fever. In severe cases a grey or white patch develops in the throat. This can block the airway and create a barking cough as in croup. The neck may swell in part due to large lymph nodes.  form of diphtheria that involves the skin, eyes, or genitals also exists. Complicatio may include myocarditis, inflammation of nerves, kidney problems, and bleeding problems due to low blood platelets. Myocarditis may result in an abnormal heart rate and inflammation of the nerves may result in paralysis.

Specialty:	Infectious Disease
MeSH Code:	D004165
ICD 9 Code:	32

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