A Sneak Peek at What's Inside
What is Diphtheria
It is an acute, highly contagious toxin-mediated infection caused by Corynebacterium diphtheriae.It usually infects the respiratory tract, primarily involved the tonsils, nasopharynx and larynx. It can also be defined as a serious bacterial infection usually affecting the mucous membranes of your nose and throat caused by Corynebacterium diphtheriae.It is transmitted through direct contact with secretions from carriers or infected individuals. It is also spread by airborne respiratory droplets from infected persons through coughing or sneezing. Incidence is high during cold months. Incubation period of the condition is between 2 to 4 days. Rarely, transmission is through touching open sores (skin lesions) or clothes that has touched open sores of someone with diphtheria. A person also can get diphtheria by coming into contact with an object such as a toy that has the bacteria that cause diphtheria on it.
Pathophysiology of Diphtheria
The bacteria that cause diphtheria spread through respiratory droplets such as from cough or sneeze of an infected person or a carrier. The bacteria get into and attach to the lining of the respiratory tract, and commonly infects the nose and throat. Whiles attached to the lining of the respiratory tract; the bacteria make dangerous substances called toxins. The toxins destroy healthy tissues in the respiratory system. The dead tissues form a thick, gray coating that builds up in the throat. The gray to black tough, fiber-like covering in the throat blocks the airways, and makes breathing difficult. The thick gray coating also covers tissues in the nose, tonsils, and voice box. In some cases, diphtheria first infects the skin and causes skin lesions. The toxins spread through the bloodstream to other organs such as the kidneys, heart and brain, and cause damage to them.
Signs & Symptoms of Diphtheria
- Sore throat
- Cough
- Nasal discharge
- Swollen glands (enlarged lymph nodes) in the neck
- Cyanosis
- The hallmark sign is a thick, gray material or patch covering the throat
Diagnostic Investigations & Test
- Nasopharyngeal secretions for culture and sensitivity
- Throat swab for culture and sensitivity
- Wound swab for culture and sensitivity
- Full blood count
- Physical examination
- Electrocardiogram (ECG)
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Diphtheria Treatment
- IV Diphtheria antitoxin to stop the toxin produced by the bacteria from damaging the body
- Antibiotics such as penicillin and erythromycin
- Intravenous fluids for rehydration
- Analgesics for pain
- Supplemental oxygen
Nursing Management of Diphtheria
The following are the measures to put in place in the care of patient's with Diphtheria
- Isolation and barrier nursing.
- Ensure complete bed rest
- Monitor intake and output
- Monitor vital signs
- Encourage patient to take copious oral fluids
- Administer prescribed drugs
- Administer oxygen PRN or as ordered
- Trace and identify contact for test and refer if necessary
Complications of Diphtheria
- Myocarditis (damage to the heart muscle)
- Neuritis (inflammation of the neuron)
- Nerve damage (polyneuropathy)
- Loss of the ability to move (paralysis)
- Nephritis (inflammation of the nephron)
- Hepatitis
- Lung infection (respiratory failure or pneumonia)
Preventions of Diphtheria
- Routine childhood immunizations.
- Anyone who has come into contact with an infected person should get an immunization or booster shot against diphtheria, if they have not already received it.
- Protection from the vaccine lasts only 10 years. It is therefore important for adults to get a booster vaccine every 10 years.
