This acute, highly contagious infection is characterized by a grayish membrane that coats the throat. In the disease’s early stages, other symptoms usually include a sore throat, low fever, and swollen glands in the neck During later stages, the patient may experience difficulty in swallowing or breathing; he may also have a profuse discharge from the nose plus a rapid heartbeat. Although many people think of diphtheria as a children’s disease, it can actually strike at any age. The organism that causes diphtheria is Corynebacterium diphtheriae, which spreads by way of droplets expelled during coughing, sneezing, or simply breathing. Some strains of the bacterium produce a poisonous exotoxin that travels through the bloodstream and attacks the nerves, heart, kidneys, and reproductive organs. The results can be nerve and heart inflammation, heart failure, shock, and even death.
Diagnostic Studies And Procedures
Because diphtheria is rare in the United States and other industrialized countries, most doctors in these areas have never encountered it and so may not recognize it. Once the classic gray membrane appears, however, a physician will probably suspect diphtheria. A culture for the bacterium, obtained from a sample of throat secretions, can confirm a diagnosis.
This disease is so contagious that any one who has it must be isolated, usually in a hospital intensive care unit. The diphtheria antitoxin should be given immediately. This will neutralize the exotoxin, but only that which has not yet attacked body cells; it’s less effective, there fore, if given later in the course of the disease. An antibiotic usually penicillin or erythromycin is also needed to kill the bacteria. Depending on the severity of the disease and the presence of complications, supplemental oxygen may be given, and the lungs, heart, and nervous system might be monitored for further signs of complications. If the throat has swollen, artificial respiration may be needed to prevent the patient from suffocating. Recuperation can be lengthy, particularly if there are heart complications. Bed rest is essential, sometimes for two or three months in severe cases. Anyone exposed to diphtheria should find out when they were last immunized against the disease, and receive, if necessary, a booster shot or a complete course of immunizations.
Diphtheria is a medical emergency requiring prompt treatment with the diphtheria antitoxin. Any alternative therapies must be used strictly as an adjunct to this medical care.
During convalescence, soothing scents may help relax an irritable or restless patient; place a bowl of steaming water containing aromatic oils at the person’s bedside. Bach flower remedies may also be used to foster emotional well being.
Swedish or other therapeutic massages can help to relax the convalescent. Massage may also tone muscles in preparation for a gradual return to normal physical activity.
Diphtheria requires medical treatment, but you can take measures to prevent the disease. Keep your immunizations up to date, an adult should have a diphtheria booster shot at least every 10 years. If it has been longer since your last one, you need a complete three dose series of immunizations. This is especially important if you plan to travel to any country that has had recent outbreaks of the disease. Make sure that children receive the diphtheria vaccine at 2,4, 6, and 18 months of age. They also need a booster shot when they begin school (usually between the ages of 4 and 6 years) and every 5 to 10 years after that. For young children, the diphtheria vaccine is usually combined with pertussis and tetanus immunizations in what is called the DPT shot. Although some youngsters do suffer adverse reactions to this injection, they are generally responding to the pertussis component and not the diphtheria vaccine. A child who has previously had an adverse reaction to the DPT shot or who has ever had a seizure or convulsion, should not receive the pertussis vaccine but should be given the diphtheria and tetanus vaccines, which can still be combined in a single shot.
Other Causes of Throat Symptoms
The early symptoms of diphtheria are similar to those of flu, a cold, strep throat, or other upper respiratory infections. Mononucleosis or scarlet fever may cause a very sore throat with no other cold symptoms.