Diphtheria: symptoms, treatment, photo, prevention
What is it? Diphtheria is one of the most serious, both in treatment and diagnosis, of infectious diseases that occurs in children and adults.
It develops due to ingress of a special kind of bacteria into the body, proceeds quite sharply and requires immediate treatment.
In diphtheria, not only inflammation of the organs affected by the bacterium is observed, but also a general strong intoxication of the body.
To date, this disease, due to mandatory routine vaccinations, is not common, but it is considered quite dangerous, as it threatens the life of the patient.
The cause of diphtheria in a healthy person is the ingestion of a special kind of bacteria known in the scientific community under the name Corynebacterium diphtheriae. This type of bacteria is an aerobic and does not form capsules or spores.
Diphtheria exotoxin, which secretes toxigenic strains of bacteria, is considered to be the direct causative agent of the disease. But bacteremia for such cases is not typical. Diphtheria exotoxin belongs to the group of the most toxic bacterial poisons, conceding in this hierarchy only to tetanus( see tetanus symptoms) and botulinum toxins.
Diphtheria belongs to the category of infectious diseases. Infection occurs mainly through the mucous membranes of the nose and mouth, while the rod is transported by airborne droplets. In rare cases, the diphtheria bacillus may be found in certain foods: confectionery, dairy products.
Through the mucous diphtheria exotoxin enters the bloodstream and spreads through the body through the lymphatic and blood vessels. In this case, the symptoms of intoxication are intensified, and soft tissue swelling occurs.
Exotoxin can affect almost any cell of the human body, but most often the target is lymphocytes, cardiomyocytes, arterial endothelial cells, oligodendrogliocytes.
The first sign of beginning diphtheria in children and adults is a slightly elevated body temperature, which lasts a fairly long period of time. Then the temperature is joined by such symptoms as: discharge from the foci of inflammation, their edema and a slight soreness.
Most often such a focus is the oropharynx, less often - the ear, nasopharynx, eyes, genitals, skin. For diphtheria of the pharynx, which is about 90% of all cases, the formation of a grayish tinge on the tonsils is characteristic. At the expiration of a week, this plaque increases in size, while making breathing difficult.
To date, there are several of the most dangerous forms of diphtheria, which require immediate intervention of doctors and the appointment of appropriate therapy.
The danger of diphtheria is mainly that it is difficult to diagnose. The clinical picture in this disease has many symptoms, which are typical for other diseases. However, there are a number of features that help to distinguish diphtheria from the number of similar diseases:
For bacteriological inoculation, a sample of excreta is taken from the posterior pharyngeal wall. A similar study establishes the presence or absence of diphtheria bacillus. But the serological test shows the level of diphtheria antitoxin, while the blood of the patient is used for the analysis.
Treatment of all patients who have confirmed the presence of diphtheria is mandatory in the hospital. Hospitalization is carried out at any stage of the disease, and in particularly severe cases, people can be placed in the department of infectious resuscitation.
The main drug in the treatment of diphtheria to date is antidiphtheria serum, which is injected intramuscularly. The highest effect of its effect on diphtheria bacillus is observed if the drug was used at the very beginning of the disease. Serum is administered, as a rule, once, but in some cases it is possible to repeat the injection. According to recent studies, the dose is selected individually depending on the form of diphtheria.
With the toxic form of diphtheria, in some cases, the use of an antibiotic is recommended. Most often it is penicillin or erythromycin. To remove swelling, use antihistamines, in some cases, for example, in the detection of stenosis, prescribe prednisolone. Also, all patients undergo disintoxication therapy using droppers with colloidal and crystalloid solutions.
Also read the symptoms and treatment of malaria.
To date, the best result in the prevention of diphtheria has been vaccination, which is carried out with a drug containing diphtheria toxoid.
The adult population is recommended to be vaccinated every 10 years with the drug ADS-M.
Despite the fact that physicians insist on vaccination against diphtheria, vaccination, like the diphtheria transferred in the past, does not guarantee that the person will not get sick. However, those who receive the vaccine, the disease is much easier, without severe intoxication and complications.
Given the fact that diphtheria is easily transmitted from an infected person to a healthy person, it is very important to isolate the patient as much as possible, from which the diphtheria bacillus has been identified. It is easiest to do this in a hospital to an infectious diseases hospital.
After complete recovery, the patient is discharged from the hospital only after two tests for the presence of a diphtheria causative agent, showed a negative result. All people who have been in contact with the patient should be examined carefully, if necessary, take samples for the necessary tests. Such measures will help to avoid the development of the epidemiological situation.
It develops due to ingress of a special kind of bacteria into the body, proceeds quite sharply and requires immediate treatment.
In diphtheria, not only inflammation of the organs affected by the bacterium is observed, but also a general strong intoxication of the body.
To date, this disease, due to mandatory routine vaccinations, is not common, but it is considered quite dangerous, as it threatens the life of the patient.
What is it - the reasons for the development of diphtheria
The cause of diphtheria in a healthy person is the ingestion of a special kind of bacteria known in the scientific community under the name Corynebacterium diphtheriae. This type of bacteria is an aerobic and does not form capsules or spores.
Diphtheria exotoxin, which secretes toxigenic strains of bacteria, is considered to be the direct causative agent of the disease. But bacteremia for such cases is not typical. Diphtheria exotoxin belongs to the group of the most toxic bacterial poisons, conceding in this hierarchy only to tetanus( see tetanus symptoms) and botulinum toxins.
Diphtheria belongs to the category of infectious diseases. Infection occurs mainly through the mucous membranes of the nose and mouth, while the rod is transported by airborne droplets. In rare cases, the diphtheria bacillus may be found in certain foods: confectionery, dairy products.
Through the mucous diphtheria exotoxin enters the bloodstream and spreads through the body through the lymphatic and blood vessels. In this case, the symptoms of intoxication are intensified, and soft tissue swelling occurs.
Exotoxin can affect almost any cell of the human body, but most often the target is lymphocytes, cardiomyocytes, arterial endothelial cells, oligodendrogliocytes.
Symptoms of diphtheria
The first sign of beginning diphtheria in children and adults is a slightly elevated body temperature, which lasts a fairly long period of time. Then the temperature is joined by such symptoms as: discharge from the foci of inflammation, their edema and a slight soreness.
Most often such a focus is the oropharynx, less often - the ear, nasopharynx, eyes, genitals, skin. For diphtheria of the pharynx, which is about 90% of all cases, the formation of a grayish tinge on the tonsils is characteristic. At the expiration of a week, this plaque increases in size, while making breathing difficult.
To date, there are several of the most dangerous forms of diphtheria, which require immediate intervention of doctors and the appointment of appropriate therapy.
- Toxic form is one of the most common. It develops very quickly: literally in three days the disease goes through all stages - from a sharp rise in temperature to intoxication of the body. There are painful sensations in the abdomen, quite strong swelling of the affected organs. Most often, the neck and nearby areas swell.
- Hypertensive form is characterized by the fact that the symptoms of intoxication with it have the most vivid picture. In addition to high fever and severe puffiness, convulsions are observed, the patient falls into an unconscious state. In the absence of treatment, death occurs within a few days due to heart failure.
- With haemorrhagic form, the hematopoietic system is affected. During this severe form of diphtheria, hemorrhagic eruptions throughout the body, hemorrhage in the mucous, gastrointestinal tract are observed.
Diagnosis
The danger of diphtheria is mainly that it is difficult to diagnose. The clinical picture in this disease has many symptoms, which are typical for other diseases. However, there are a number of features that help to distinguish diphtheria from the number of similar diseases:
- acute onset of
- disease with a plaque on the tonsils, sore throat absent or moderate
- swelling of the mucous oropharyngeal often combined with edema of the submaxillary space
- lymph nodes moderately enlarged and almost painless
For bacteriological inoculation, a sample of excreta is taken from the posterior pharyngeal wall. A similar study establishes the presence or absence of diphtheria bacillus. But the serological test shows the level of diphtheria antitoxin, while the blood of the patient is used for the analysis.
Treatment of diphtheria
Treatment of all patients who have confirmed the presence of diphtheria is mandatory in the hospital. Hospitalization is carried out at any stage of the disease, and in particularly severe cases, people can be placed in the department of infectious resuscitation.
The main drug in the treatment of diphtheria to date is antidiphtheria serum, which is injected intramuscularly. The highest effect of its effect on diphtheria bacillus is observed if the drug was used at the very beginning of the disease. Serum is administered, as a rule, once, but in some cases it is possible to repeat the injection. According to recent studies, the dose is selected individually depending on the form of diphtheria.
With the toxic form of diphtheria, in some cases, the use of an antibiotic is recommended. Most often it is penicillin or erythromycin. To remove swelling, use antihistamines, in some cases, for example, in the detection of stenosis, prescribe prednisolone. Also, all patients undergo disintoxication therapy using droppers with colloidal and crystalloid solutions.
Also read the symptoms and treatment of malaria.
Prevention
To date, the best result in the prevention of diphtheria has been vaccination, which is carried out with a drug containing diphtheria toxoid.
Vaccination is started in childhood with DTP or ADP vaccines, which are combined drugs and include the prevention of other dangerous diseases as well.
The adult population is recommended to be vaccinated every 10 years with the drug ADS-M.
Despite the fact that physicians insist on vaccination against diphtheria, vaccination, like the diphtheria transferred in the past, does not guarantee that the person will not get sick. However, those who receive the vaccine, the disease is much easier, without severe intoxication and complications.
Given the fact that diphtheria is easily transmitted from an infected person to a healthy person, it is very important to isolate the patient as much as possible, from which the diphtheria bacillus has been identified. It is easiest to do this in a hospital to an infectious diseases hospital.
After complete recovery, the patient is discharged from the hospital only after two tests for the presence of a diphtheria causative agent, showed a negative result. All people who have been in contact with the patient should be examined carefully, if necessary, take samples for the necessary tests. Such measures will help to avoid the development of the epidemiological situation.