Diphtheria Facts (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Jerry R. Balentine, DO, FACEP
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
In this Article
- Diphtheria facts
- What is diphtheria?
- What are the symptoms and signs of diphtheria?
- What is the history of diphtheria?
- What causes diphtheria?
- What are risk factors for diphtheria?
- How do physicians diagnose diphtheria?
- What is the treatment for diphtheria?
- What are possible complications of diphtheria?
- What is the prognosis of diphtheria?
- Is it possible to prevent diphtheria? Is there a diphtheria vaccine?
What causes diphtheria?
The cause of diphtheria is bacterial species termed Corynebacterium diphtheriae, a gram-positive bacillus that usually produces exotoxins. There are three main strains of C. diphtheriae: gravis, intermedius, and mitis. The strain termed intermedius is most often associated with exotoxin production although all three strains are capable of producing exotoxin. The organisms easily invade the tissue lining the throat, and during that invasion, they produce exotoxins that destroy the tissue and lead to the development of a pseudomembrane. The exotoxin production is dependent upon a viral genome that is present within the bacteria. This viral genome is copied when the bacteria multiplies; if the viral genome is lost, diphtheria exotoxin is not produced. Non-toxin-producing strains and other Corynebacterium species such as C. ulcerans can still cause infection, but infection is less severe and sometimes remains only in the skin (cutaneous infection).
What are risk factors for diphtheria?
Because human carriers or symptomatic individuals are the main reservoir for infection, situations such as overcrowding (dormitories, institutional housing, poor living conditions), incomplete immunization, and people who are immunodepressed are at higher risk for getting diphtheria. Diphtheria is transmitted by inhalation of airborne droplets or by direct contact with infected patients by mucous secretions or skin ulcerations. Some people may carry the bacteria in their respiratory tracts (termed carriers) but do not exhibit disease. However, such individuals can still transmit the organisms to uninfected individuals.
How do physicians diagnose diphtheria?
Preliminary diagnosis of diphtheria is usually made from the patient's history and physical exam and the presence of a pseudomembrane formation in the throat. Confirmation is based on isolation of the organism from swab specimens taken from the throat or from skin lesions. However, because diphtheria can be lethal, the CDC recommends immediate treatment if diphtheria suspected; do not wait for laboratory confirmation.
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