How to Manage Diphtheria

Diphtheria is an acute condition that a bacterium called Corynebacterium diphtheriae causes. It spreads by respiratory droplets. It is extremely rare in the United States today (less than five cases per year), but the disease can be fatal, especially in individuals with compromised immune systems. The bacteria that causes diphtheria releases a toxic substance that causes the condition’s signs and symptoms. This usually happens within two to five days of exposure.

Instructions

Difficulty: Moderate

Things You’ll Need:

• A proper medical diagnosis
• An appropriate treatment plan
• Time to rest and recover

1. Learn the signs and symptoms of diphtheria. Often, people infected with the bacteria that cause diphtheria develop general cold and flu symptoms, like a sore throat, difficulty swallowing, fatigue and low-grade fevers. Children, in particular, might also have nausea, vomiting and higher fevers. There is a “pseudomembrane” stuck to the tonsils, pharynx or nose. Infected individuals sometimes develop a swollen neck. The pseudomembrane is a tough, dark fiber that covers one or more of these areas. The disease is associated with a risk of death, and the presence of a swollen neck increases that risk. People with diphtheria also might have a “racing” heart, or appear pale or languid.
2. See your doctor to confirm diphtheria. A physician can take a clinical specimen from the patient with diphtheria signs and symptoms and obtain a laboratory diagnosis; however, a clinical diagnosis–based on the signs and symptoms–can be enough to initiate treatment.
3. Remember that prompt diagnosis and treatment are important. Diphtheria can be a minor illness, but it can also lead to death. Both the infected individual and any close contacts should undergo treatment if a physician confirms that a person has diphtheria. If there is a solid clinical diagnosis, most clinicians will administer the diphtheria antitoxin before receiving a laboratory confirmation, because there is a greater risk of death associated with waiting to administer an antitoxin. While antibiotics do not help with the local infection, the CDC does recommend giving antibiotics to infected individuals and carriers to prevent transmission of the bacteria that causes diphtheria. Antibiotics used could be a type of penicillin, erythromycin, rifampin or clindamycin. Fluid, bed rest and sometimes oxygen are important for recovery.
4. Watch for breathing difficulties. Seek immediate medical attention if breathing becomes at all difficult. Diphtheria usually causes a pseudomembrane in the throat, which can obstruct the airway. Such obstruction will prevent the patient’s ability to breathe. It is therefore important in the event of even a slight breathing difficulty to prepare to secure the patient’s airway via intubation or a tracheotomy.
5. Watch for heart problems. Diphtheria can result in arrhythmias or disorganized heart rates that heart monitoring can detect. This infection can cause cardiomyopathy or myocarditis.
6. Watch for skin problems. There is cutaneous (skin) form of diphtheria, which can cause a lesion on the leg or elsewhere. It usually follows some other skin problem by about a week. Sometimes a skin infection precedes a respiratory infection. Diptheria can lead to peripheral neuropathy or temporary paralysis.
7. Manage patients with moderate-to-severe diphtheria in a hospital setting. The toxin can damage other organs (e.g. kidney) or cause nerve damage. Because of the potential for breathing difficulties and cardiac problems, management in a hospital setting is prudent.

Tips & Warnings

• This article is for information purposes only and does not constitute medical advice. Always contact a medical practitioner for information about diagnosis, treatment and prognosis.