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9 Cards in this Set
- Front
- Back
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Epidemiology |
Asymptomatic respiratory tract carriage is important in transmission. Where diphthe- ria is endemic, 3-5% of healthy individuals can carry toxigenic organ- isms, but carriage is exceedingly rare if diphtheria is rare. Skin infection and skin carriage are silent reservoirs of C. diphtheriae, and organisms can remain viable in dust or on fomites for up to 6 mo. Transmission through contaminated milk and through an infected food handler has been proven or suspected. |
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Types of infection |
Mucous membrane Skin infection
compared with mucosal infection, is associated with more prolonged bacterial shed- ding, greater contamination of the environment, and increased trans- mission to the pharynx and skin of close contact |
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Complications |
Toxin absorp- tion can lead to systemic manifestations: kidney tubule necrosis, thrombocytopenia, cardiomyopathy, and/or demyelination of nerve |
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Toxin absorp- tion can lead to systemic manifestations: kidney tubule necrosis, thrombocytopenia, cardiomyopathy, and/or demyelination of nerve |
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Respiratory Tract Diphtheria |
primary focus of infection was the tonsils or pharynx (94%), with the nose and larynx the next 2 most common sites. |
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Nose infection |
Infection of the anterior nares is more common among infants and causes serosanguineous, purulent, erosive rhinitis with membrane formation. Shallow ulceration of the external nares and upper lip is characteristic. |
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tonsillar and pharyngeal diphtheria |
ore throat is the universal early symptom. Only half of patients have fever, and fewer have dysphagia, hoarseness, malaise, or headache. Mild pha- ryngeal injection is followed by unilateral or bilateral tonsillar mem- brane formation, which can extend to involve the uvula (which may cause toxin-mediated paralysis), sof palate, posterior oropharynx, hypopharynx, or glottic areas |
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Differences from other causes of membrane |
Te characteristic adherent membrane, extension beyond the faucial area, dysphagia, and relative lack of fever help diferentiate diphtheria from exudative pharyngitis caused by Streptococcus pyogenes or Epstein-Barr virus. |
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Difference between Tdap and DTap |
In Tdap. Diphtheria toxoid is only 10 % Compared to that of DTap |
