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Diphtheria

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Diphtheria, Pseudomembranous Pharyngitis, Corynebacterium diphtheriae

  • Epidemiology
  1. Rare in United States due to Immunization (DTP, DTaP)
    1. However 20% of adults may be inadequate immune status
  2. Ongoing epidemic in the former USSR
  • Etiology
  1. Corynebacterium diphtheriae
  • Symptoms
  1. Sore Throat
  2. Dysphagia
  3. Weakness
  4. Malaise
  • Signs
  1. Toxic appearance
  2. Fever
  3. Tachycardia (out of proportion to fever)
  4. Pharyngeal erythema
  5. Gray-white tenacious exudate or "membrane"
    1. Occurs at Tonsillar Pillars and posterior pharynx
    2. Leaves focal hemorrhagic raw surface when removed
  6. Cervical Lymphadenopathy
  • Differential Diagnosis
  1. Vincent's Angina (Trench Mouth)
    1. Also shows pseudomembrane formation
  2. Pharyngitis
  • Labs
  1. Complete Blood Count (CBC)
    1. Leukocytosis
  2. Throat Culture
    1. Positive for Corynebacterium organisms
  • Management
  1. Diphtheria antitoxin
  2. Erythromycin 20-25 mg/kg q12 hours IV for 7-14 days
  • Prevention
  1. DTP Vaccination or DTaP Vaccination