Diphtheria (cont.)
How is diphtheria diagnosed?
The diagnosis of diphtheria is confirmed by isolation of the bacterium
Corynebacterium diphtheriae. Diagnostic tests to isolate the bacterium involve
obtaining cultures from the nose and throat in any individual suspected of
having diphtheria, as well as their close contacts.
It is also important to determine whether or not the isolate is capable of
producing diphtheria toxin, and this can be accomplished by testing in
specialized laboratories. Finally, determining the patient's antibody levels to
diphtheria toxin can also be helpful for evaluating the probability of the
diagnosis of diphtheria and the potential for severe illness.
Other tests, such as ECG, imaging studies, and blood work can also help
assess the extent of involvement of the disease.
What is the treatment for diphtheria?
If diphtheria is suspected in a patient, prompt treatment should be
undertaken even before confirmatory lab results are available.
Diphtheria antitoxin is the mainstay of therapy. It neutralizes circulating
diphtheria toxin and reduces the progression of the disease. The effectiveness
of diphtheria antitoxin is greatest if it is administered early in the course of
the disease. The U.S. Centers for Disease Control and Prevention (CDC) can
assist in obtaining the diphtheria antitoxin. Antitoxin is not recommended for
asymptomatic carriers and it is usually of no value in localized cutaneous
diphtheria.
Antibiotics should also be administered as soon as possible to patients with
suspected diphtheria. Antibiotics help eradicate the bacteria, thereby stopping
toxin production, and they also help to prevent transmission of diphtheria to
close contacts. Penicillin and erythromycin are the recommended antibiotics.
Asymptomatic carriers, as well as all close contacts potentially exposed to
diphtheria, also require antibiotic treatment.
Supportive measures, such as inserting a breathing tube (intubation), may be
necessary if the patient cannot breathe on their own or if there is the
potential for airway obstruction. Potential cardiac and neurologic complications
also need to be closely followed and addressed in consultation with the proper
specialist.
Next: What are the complications of diphtheria? »
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