Diphtheria Dr Sarma R V S N Consultant

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Diphtheria Dr. Sarma R V S N Consultant Physician Revised May 2007

Diphtheria Dr. Sarma R V S N Consultant Physician Revised May 2007

Diphtheria Greek diphthera (leather hide) Caused by Aerobic Gram +ve rods Cornyebacterium diphtheriae Exotoxin

Diphtheria Greek diphthera (leather hide) Caused by Aerobic Gram +ve rods Cornyebacterium diphtheriae Exotoxin production only if infected by virus phage infected carrying toxin gene

Gram +ve Bacilli and Colonies

Gram +ve Bacilli and Colonies

Diphtheria Epidemiology Reservoir Human carriers Usually asymptomatic Transmission Respiratory Skin and fomites rarely Temporal

Diphtheria Epidemiology Reservoir Human carriers Usually asymptomatic Transmission Respiratory Skin and fomites rarely Temporal pattern Winter and spring Communicability Up to several weeks without antibiotics

Diphtheria Clinical Features Incubation period 2 -5 days (range, 1 -10 days) May involve

Diphtheria Clinical Features Incubation period 2 -5 days (range, 1 -10 days) May involve any mucous membrane Classified based on site of infection anterior nasal pharyngeal and tonsillar laryngeal cutaneous ocular genital

Pharyngeal and Tonsillar Diphtheria Insidious onset of exudative pharyngitis Exudate spreads within 2 -3

Pharyngeal and Tonsillar Diphtheria Insidious onset of exudative pharyngitis Exudate spreads within 2 -3 days and may form adherent pseudo membrane Membrane may cause respiratory obstruction Fever usually not high but patient appears toxic

Thick Membrane

Thick Membrane

Pseudo membrane

Pseudo membrane

‘Bull Neck’

‘Bull Neck’

Skin Lesions

Skin Lesions

Diphtheria Complications Mostly attributable to toxin Severity generally related to extent of local disease

Diphtheria Complications Mostly attributable to toxin Severity generally related to extent of local disease Most common complications are myocarditis and toxic neuritis with palsy Death occurs in 5%-10% for respiratory disease

Diphtheria Antitoxin (DAT) Produced in horses First used in the U. S. in 1891

Diphtheria Antitoxin (DAT) Produced in horses First used in the U. S. in 1891 Used only for treatment of diphtheria Neutralizes only unbound toxin

Diphtheria – in USA, 1940 -2005* *2005 provisional total Year

Diphtheria – in USA, 1940 -2005* *2005 provisional total Year

DTa. P, DT, and Td DTa. P, DT Td, Tdap (adult) Diphtheria 7 -8

DTa. P, DT, and Td DTa. P, DT Td, Tdap (adult) Diphtheria 7 -8 Lf units Tetanus 5 -12. 5 Lf units 2 -2. 5 Lf units

Diphtheria Pertussis and Tetanus Dr Kalyan Diphtheria EpidemiologyDiphtheria Pertussis and Tetanus Dr Kalyan Diphtheria Epidemiology
Diphtheria and Diphtheria Toxoid Epidemiology and Prevention ofDiphtheria and Diphtheria Toxoid Epidemiology and Prevention of
DIPHTHERIA DIPHTHERIA is an acute infectious disease causedDIPHTHERIA DIPHTHERIA is an acute infectious disease caused
Diphtheria 28 nvember 2008 Tinna Baldvinsdttir Diphtheria nDiphtheria 28 nvember 2008 Tinna Baldvinsdttir Diphtheria n
Diphtheria and Diphtheria Toxoid Epidemiology and Prevention ofDiphtheria and Diphtheria Toxoid Epidemiology and Prevention of
Palantr Coordinating Distributed CM Workspaces Anita Sarma AndrPalantr Coordinating Distributed CM Workspaces Anita Sarma Andr
Public Finance Paresh Kr Sarma Ho D DepartmentPublic Finance Paresh Kr Sarma Ho D Department
Market Structures Umesh Ch Sarma Asstt Professor DepartmentMarket Structures Umesh Ch Sarma Asstt Professor Department
Dr R V S N Sarma M DDr R V S N Sarma M D
HYPERCALCEMIA Dr R V S N Sarma MHYPERCALCEMIA Dr R V S N Sarma M
Data Integration with Dependent Sources Anish Das SarmaData Integration with Dependent Sources Anish Das Sarma
ARTERIAL STIFFNESS Dr R V S N SarmaARTERIAL STIFFNESS Dr R V S N Sarma
RESISTANT HYPERTENSION Prof Dr Sarma VSN Rachakonda MRESISTANT HYPERTENSION Prof Dr Sarma VSN Rachakonda M