diphtheria

Sophie Matzik is a freelance writer for the medical team.

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Diphtheria is an acute infection that can be life threatening. It is caused by a bacterium that is transmitted by coughing or sneezing. Possible signs of diphtheria include a sore throat, difficulty swallowing, fever, and fatigue. They are caused by the poison produced by the bacteria. Read everything you need to know about diphtheria here.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. A36

Diphtheria: description

Diphtheria is an acute bacterial infection. It mostly affects the upper respiratory tract, especially the lining of the throat.

The triggering bacteria are transmitted from person to person by coughing, sneezing or speaking (droplet infection). As soon as they have settled in the lining of the throat, they start to produce a poison (toxin). This poison is responsible for the symptoms of diphtheria such as a sore throat and fever. It can also spread further in the body and damage the heart and other important organs. Doctors call this toxic diphtheria. In such cases - and if the disease is left untreated - life can be in danger.

In Germany there is an obligation to report diphtheria: both the suspicion and the actual illness and death from diphtheria must be reported by the doctor to the Ministry of Health with the name of the person concerned.

The disease can be prevented with a diphtheria vaccination. Since vaccination was introduced in Germany, the number of new cases has fallen sharply. Nonetheless, local epidemics often occur because people repeatedly refuse to be vaccinated.

Diphtheria: symptoms

The period between infection and the onset of the disease (incubation period) is relatively short: the first diphtheria symptoms appear just one to five days after infection.

The symptoms usually begin in the throat. The poison produced by the bacteria causes the mucous membranes to swell. There is a sore throat, difficulty swallowing, fever and a general feeling of illness. The neck is usually swollen visibly from the outside. There are also hoarseness, coughing and swelling of the lymph nodes.

Whitish-yellow coatings form on the almonds. They are called pseudomembranes and are a sure sign of diphtheria to the doctor. The plaque can spread to the throat and / or the windpipe and nose. If you try to peel it off, the lining underneath will start to bleed.

During the entire duration of the illness, a sweetish, putrid halitosis occurs.

It becomes dangerous when the disease spreads to the larynx. Here, too, the mucous membranes swell. This swelling initially leads to a barking cough (the so-called croup cough) and hoarseness. If the swelling increases, you may experience difficulty breathing. At this stage the disease is life-threatening!

In rare cases, the bacterial poison spreads to the internal organs. Then symptoms such as cardiac arrhythmias, swallowing paralysis (when nerves are affected), pneumonia, kidney or liver failure can lead to death.

If the bacteria get into an open wound, ulcers can form, the skin or wound diphtheria.

In children and infants, the nasal mucosa is also often affected. In such cases, a bloody or purulent discharge appears from the nose.

In the early stages, diphtheria can be confused with tonsillitis, laryngitis, or pseudo-croup.

Diphtheria: causes and risk factors

Diphtheria is caused by the bacterium Corynebacterium diphtheriae. It forms a poison in the body, the so-called diphtheria toxin. This damages the mucous membranes and destroys the body cells.

The infection occurs from person to person, mostly in the form of a droplet infection (coughing, sneezing, speaking). Even before the first symptoms of diphtheria break out, those affected are contagious, so they can pass the pathogen on to other people.

Diphtheria: examinations and diagnosis

In diphtheria, a distinction is made between the suspected diagnosis and the actual diagnosis:

The doctor makes the suspected diagnosis based on the symptoms.

For the actual, reliable diagnosis, the diphtheria bacterium must be detected. To do this, the doctor takes a swab from the lining of the throat or nose with a cotton swab. This smear is examined in the laboratory for the pathogen and its poison. However, the results are only available after twelve hours. That is why the doctor often starts therapy when diphtheria is suspected.

Diphtheria: treatment

The patient is given an antidote to the diphtheria toxin (diphtheria antitoxin). This neutralizes the poison that is free in the body and makes it harmless. However, the antidote cannot do anything against the toxin that is already bound to body cells.

The diphtheria bacterium is combated directly with antibiotics. Antibiotics are usually given over ten days. The aim is to stop the pathogen from multiplying and producing poison. The most widely used antibiotic is penicillin.

Another important treatment measure is bed rest for at least four weeks.

Immediately after the diagnosis, those affected are isolated, i.e. they are placed in quarantine. Only people who have adequate vaccination protection are allowed to come into contact with the patient.

All people who had contact with the sick person before the quarantine will also be examined for diphtheria. In most cases you will receive an antibiotic (prophylaxis) as a precaution. In the case of non-vaccinated contact persons, the vaccination will be made up immediately.

Diphtheria vaccination

The disease can be effectively prevented with a diphtheria vaccination. You can read more about this in the article Diphtheria vaccination

Diphtheria: disease course and prognosis

The prognosis for diphtheria depends on two factors: the stage at which diphtheria is recognized and the general health of the person affected. If therapy is started early, the prognosis is good and patients can usually be completely cured.

However, the disease can also cause various complications that also affect the prognosis. In severe cases of illness, patients can die from heart failure or suffocation, for example.

In general, around five to ten percent of all those affected die from diphtheria infection. In countries where medical care is good, mortality is lower. In contrast, in areas with poor medical care, such as many developing countries, the death rate from diphtheria is significantly higher.

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