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Note: Please don't include any URLs in your comments, as they will be removed upon submission. We do not store details you enter into this form. Please see our privacy policy for more information. Click here to return to the Medical News Today home page. The hallmark sign is a sheet of grayish material that covers the back of the throat. It is rare in the Western world, but it can be fatal if left untreated. Diphtheria is a highly contagious bacterial infection of the nose and throat. Thanks to routine immunization, diphtheria is a disease of the past in most parts of the world.

There have only been five cases of the bacterial infection in the United States in the last 10 years. In countries where there is a lower uptake of booster vaccines, however, such as in India, there remain thousands of cases each year.


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In people who are not vaccinated against the bacteria that cause diphtheria, infection can cause serious complications, such as nerve problems, heart failure, and even death. Overall, 5 to 10 percent of people who get infected with diphtheria will die. Some people are more vulnerable than others, with a mortality rate of up to 20 percent in infected people under 5 year or older than 40 years of age. Diphtheria is an infectious disease caused by the bacterial microorganism known as Corynebacterium diphtheriae. Other Corynebacterium species can be responsible, but this is rare.

Some strains of this bacterium produce a toxin, and it is this toxin that causes the most serious complications of diphtheria. The bacteria produce a toxin because they themselves are infected by a certain type of virus called a phage. Diphtheria is an infection spread only among humans. It is contagious by direct physical contact with:. The infection can spread from an infected patient to any mucous membrane in a new person, but the toxic infection most often attacks the lining of the nose and throat.

Specific signs and symptoms of diphtheria depend on the particular strain of bacteria involved, and the site of the body affected. One type of diphtheria, more common in the tropics, causes skin ulcers rather than respiratory infection.

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These cases are usually less serious than the classic cases that can lead to severe illness and sometimes death. The classic case of diphtheria is an upper respiratory infection caused by bacteria. It produces a gray pseudomembrane, or a covering that looks like a membrane, over the lining of the nose and throat, around the area of the tonsils.

This pseudomembrane may also be greenish or blueish, and even black if there has been bleeding. Children with a diphtheria infection in a cavity behind the nose and mouth are more likely to have the following early features:. After a person is first infected with the bacteria, there is an average incubation period of 5 days before early signs and symptoms appear. After the initial symptoms have appeared, within 12 to 24 hours, a pseudomembrane will begin to form if the bacteria are toxic, leading to:.

If the membrane extends to the larynx, hoarseness and a barking cough are more likely, as is the danger of complete obstruction of the airway. The membrane may also extend further down the respiratory system toward the lungs.

Diphtheria - Wikipedia

Potentially life-threatening complications can occur if the toxin enters the bloodstream and damages other vital tissues. Myocarditis is an inflammation of the heart muscle. It can lead to heart failure, and the greater the degree of bacterial infection, the higher the toxicity to the heart.

Myocarditis might cause abnormalities that are only apparent on a heart monitor, but it has the potential to cause sudden death. Heart problems usually appear 10 to 14 days after the start of the infection, although problems can take weeks to appear. Heart problems associated with diphtheria include:. Neuritis is inflammation of nerve tissue that results in damage to nerves.

This complication is relatively uncommon and usually appears after a severe respiratory infection with diphtheria.

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Typically, the condition develops as follows:. If the bacterial infection affects tissues other than the throat and respiratory system, such as the skin, the illness is generally milder. This is because the body absorbs lower amounts of the toxin, especially if the infection only affects the skin. The infection can coexist with other infections and skin conditions and may look no different from eczema , psoriasis , or impetigo.

However, diphtheria in the skin can produce ulcers where there is no skin at the center with clear edges and sometimes grayish membranes. Other mucous membranes can become infected by diphtheria - including the conjunctiva of the eyes, women's genital tissue, and the external ear canal. There are definitive tests for diagnosing a case of diphtheria, so if symptoms and history cause a suspicion of the infection, it is relatively straightforward to confirm the diagnosis. Doctors should be suspicious when they see the characteristic membrane, or patients have unexplained pharyngitis, swollen lymph nodes in the neck, and low-grade fever.

Tissue samples taken from a patient with suspected diphtheria can be used to isolate the bacteria, which are then cultured for identification and tested for toxicity:. The tests may not be readily available, and so doctors may need to rely on a specialist laboratory. Treatment is most effective when given early, so a quick diagnosis is important. The antitoxin that is used cannot fight the diphtheria toxin once it has bound with the tissues and caused the damage.

Patients with respiratory diphtheria and symptoms would be treated in an intensive care unit in the hospital, and closely monitored. Healthcare staff may isolate the patient to prevent the spread of the infection. This will be continued until tests for bacteria repeatedly return negative results in the days following the completion of the course of antibiotics. Common Knowledge Series Deadly diseases and epidemics. Series: Deadly diseases and epidemics Series by cover.

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Series description. How do series work? Helpers supersidvicious , SimoneA 2. Series: Deadly diseases and epidemics Series by cover 1—7 of 55 next show all. Antibiotic Resistant Bacteria by Patrick G. Avian Flu by Jeffrey N. Cervical Cancer by Juliet Spencer. Diphtheria Deadly Diseases and Epidemics by Ph. Patrick Guilfoile.

Encephalitis by Ona Bloom. Gonorrhea by Linda Kollar.

History of Diphtheria

Infectious Diseases of the Mouth by Scott C. Influenza by Donald Emmeluth. Meningitis by Brian Shmaefsky. Rabies by Thomas E. Salmonella by Danielle A. Tetanus Deadly Diseases and Epidemics by Ph.