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Diphtheria

Sabrina E. Kunciw, MD and Ashley A. Roselle, DO Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Acute respiratory tract infection typically presenting as a membranous pharyngitis, caused by the gram-positive facultative anaerobic bacterium Corynebacterium diphtheriae

  • Greek name ...

DIAGNOSIS

HISTORY

  • Membranous pharyngotonsillar diphtheria

    • Sore throat

    • Malaise, fever, and prostration

  • Nasal diphtheria

    • Rhinorrhea (often unilateral)

    • Often chronic, mild course

  • Obstructive laryngotracheit...

TREATMENT

GENERAL MEASURES

  • Appropriate health care generally entails:

    • Consider admission to monitor cardiac and respiratory status (must act on presumptive diagnosis because therapy cannot wait for cu...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Rest for at least 3 weeks until risk of developing myocarditis has passed. 

Patient Monitoring

  • ECG, cardiac enzymes, neurologic status, and respiratory status; seri...

REFERENCES

1
Efstratiou A, Engler KH, Mazurova IK, et al. Current approaches to the laboratory diagnosis of diphtheria. J Infect Dis.  2000;181(Suppl 1):S138–S145. [View Abstract on OvidMedline]
2
R...

ADDITIONAL READING

  • American Academy of Pediatrics. Diphtheria. In: Pickering LK, Baker CJ, Kimberlin DW, et al, eds. Red Book: 2009 Report of the Committee on Infectious Diseases. 28th ed. Elk Grove ...

CODES

ICD10

  • A36.9 Diphtheria, unspecified

  • A36.0 Pharyngeal diphtheria

  • A36.1 Nasopharyngeal diphtheria

CLINICAL PEARLS

  • Culture, check immunization status, and consider antimicrobial prophylaxis (penicillin or erythromycin) for close contacts of known cases of C. diphtheriae.

  • Tdap is routinely recommende...

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