Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
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.
Most sore throats are caused by viruses or mechanical causes (such as mouth breathing) and can be treated successfully at home. However, a person should be seen by a health care professional if they have a sore throat that has a rapid onset, and is associated with a fever or tenderness of the front of the neck; a sore throat that causes the person to have difficulty swallowing (not just pain swallowing) or breathing; or if a sore throat lasts for more than a week.
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting from congestive heart failure may cause the body's organ systems to fail, leading to a weakened heart muscle and fluid accumulation in the lungs and body tissue. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise capacity, shortness of breath, and swelling. Treatments include lifestyle modifications, medications, heart transplant, and therapy.
An upper respiratory infection is a contagious infection of the structures of the upper respiratory tract, which includes the sinuses, nasal passages, pharynx, and larynx. Common causes of an upper respiratory infection include bacteria and viruses such as rhinoviruses, group A streptococci, influenza, respiratory syncytial, whooping cough, diphtheria, and Epstein-Barre. Examples of symptoms of upper respiratory infection include sneezing, sore throat, cough, fever, and nasal congestion. Treatment of upper respiratory infection are generally with OTC medication and home remedies.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Whooping cough (pertussis) is highly contagious respiratory infection that is caused by the bacteria Bordetella pertussis. There are an estimated 300,000 plus deaths annually from whooping cough (pertussis). Whopping cough commonly affects infants and young children, but can be prevented with immunization with the vaccine. First stage whooping cough symptoms are a runny nose, sneezing, low-grade fever, a mild cough with the cough gradually becoming more severe. After one to two weeks, the second stage of whooping cough begins.
Osteomyelitis is an infection of the bone. Potential causes include injections around the bone, fractures that puncture the skin, recent surgeries, and bacterial infections that travel from other areas of the body, spreading through the blood to the bone. Symptoms include pain, fever, chills, stiffness, and nausea. Treatment involves antibiotics and pain medications. Surgery is sometimes necessary.
Hoarseness (abnormal deep, harsh, raspy voice) is caused by a variety of conditions in which the larynx (voice box and vocal chords) are irritated or injured. Examples of causes of hoarseness include: laryngitis, straining the vocal cords by yelling or screaming, infections, GERD, allergies, and more. Treatment of hoarseness depends on the cause.
Myocarditis is an inflammation of the heart muscle and can be caused by a variety of infections, conditions, and viruses. Symptoms of myocarditis include chest pain, shortness of breath, fatigue, and fluid accumulation in the lungs. Treatment mainly involves preventing heart failure with medication and diet, as well as monitoring for heart rhythm abnormalities.
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