Diphtheria (cont.)
How is diphtheria transmitted?
Diphtheria is transmitted to close contacts via airborne respiratory droplets
or by direct contact with nasopharyngeal secretions or skin lesions. Rarely, it
can be spread by objects contaminated by an infected person. Overcrowding and
poor living conditions can further contribute to the spread of diphtheria.
Humans are the only known reservoir of Corynebacterium diphtheriae. Infected
individuals may develop symptoms of diphtheria, or they may become carriers of
the bacteria with no symptoms (asymptomatic carriers). These asymptomatic
carriers can serve as reservoirs for active infection and may transmit the
disease to other individuals.
What are the signs and symptoms of diphtheria?
The symptoms of respiratory diphtheria usually begin after a two- to five-day
incubation period. Symptoms of respiratory diphtheria may include the following:
With the progression of respiratory diphtheria, the infected individual may
also develop an adherent gray membrane (pseudomembrane) forming over the lining
tissues of the tonsils and/or nasopharynx. Individuals with severe disease may
also develop neck swelling and enlarged neck lymph nodes, leading to a
"bull-neck" appearance. Extension of the pseudomembrane into the larynx and
trachea can lead to obstruction of the airway with subsequent suffocation and
death.
The dissemination of diphtheria toxin can also lead to systemic disease,
causing complications such as inflammation of the heart (myocarditis) and
neurologic problems such as paralysis of the soft palate, vision problems, and
muscle weakness.
Cutaneous diphtheria is characterized by a non-healing skin ulcer covered by
a gray-brown membrane. It is typically a localized infection that is rarely
associated with systemic complications.
Next: How is diphtheria diagnosed? »
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