Diptheria is an acute infection involving primarily the tonsils, pharynx, larynx, and nose caused by the bacterium Corynebacterium diphtheriae.

Although rare in the United States, diphtheria remains prevalent throughout much of the world where immunization levels are low, particularly in Russia. It is caused by the inhalation of airborne droplets that are transmitted when an infected individual or asymptomatic carrier exhales. Diphtheria usually affects the respiratory system, but can infect skin wounds or any mucous membrane.

This infection may present with a thick gray membrane, which covers the throat and tonsils. Sore throat, hoarseness, weakness, fever, nasal discharge and a rapid pulse may also be part of the symptomatology.

Physical examination may be done after the incubation period (2 to 7 days) when the onset of symptoms begins. Inspection of the throat and tonsils may reveal the gray covering membrane of these areas. The Schick test may be done in adults prior to antitoxin treatment to determine susceptibility and active immunity to diphtheria. Cultures may be taken initially and again following antibiotic therapy.

Disease prevention with proper immunization is the goal of treatment. An infected individual may be isolated 10 to 14 days and require dietary modification. Diphtheria antitoxin is administered intravenously within 3 days from the time of onset, once skin testing for toxin sensitivity is determined. Prompt treatment ensures the best outcome. Antibiotics may be given to eliminate infection and carrier status. Intubation may be necessary. Non-immunized adults may receive primary immunization series of diphtheria toxoid. Two doses administered 4 to 8 weeks apart, followed by a third dose 6 to 12 months later is given. In individuals who have been previously immunized, a booster dose of Td (tetanus-diphtheria) should be given every 10 years throughout life.

Usually with proper and immediate treatment, no complications occur. Recovery from infection may be slow, but complete. The infection can result in airway obstruction from the diphtheria gray membrane. Without prompt treatment, the heart and cranial nerves can be affected.

None.