Report on Report on Diptheria, Report prepared by 1. Dr. Sajid Mahmood, MD (EU), Accident & Emergency Department, NHS Royal infirmary Liverpool United Kingdom. 2. Dr. Adnan Akram, MD (EU), Department of Infectious Diseases. University Hospital Riga Latvia
3 pages
Published by
infekcijas
Copyright :
All rights reserved
pg-1
Report on Diptheria-Etiolgy,Epid,Pathogenesis,Treatment
Etiology-toxins of corynybacterium diphtheria has two subtypes –toxicogen, non toxicogen.
it is an aerobic, non
motile non spore forming G+ rod.
3 bio types Gravis, mitis,...
[More]
pg-1
Report on Diptheria-Etiolgy,Epid,Pathogenesis,Treatment
Etiology-toxins of corynybacterium diphtheria has two subtypes –toxicogen, non toxicogen.
it is an aerobic, non
motile non spore forming G+ rod.
3 bio types Gravis, mitis, intermedius(toxicogen 3 subtypes).
it is stable in low
temp and is inactivated at >100ºC
Diphtheria toxin-heat liable polypeptide which has A and B subunit.
Incubation period :2-7 days.
Epidemiology- Airborn transmited by infected individuals or carriers( more dangerous b/c asyptomatic).
In air
droplets or direct contact.
On the mucose membrane of respiratory tract or skin abrasions.
Rarely by milk.
Pathology:Toxins are absorbed by mucous membranes causing destruction of epithelium and a superficial
inflammation the necrotic epithelium becomes embedded by fibrin, RBC,WBC and a grayish white pseudo
membrane is formed, commonly in tonsils, pharynx, larynx and nose.
Further absorption of toxins into the blood
causes distant myocardium, liver, kidney , adrenal damage.
●The pseudo membrane over tonsils, pharynx and nose is difficult to remove and any attempt of removing will
cause bleeding .
It is difficult to remove b/c these areas contain squamous epithelium.
●the membrane over larynx, trachea, bronchi is easier to remove b/c it contains cylindrical epithelium(columnar).
Forms(classification):●according to area involved common forms tonsillar, pharyngeal, laryngeal, nasal, .
rare
forms eyes, ears, genitals, umbo, skin.
● according to severity –mild, moderate, severe.
●according to progression: Fulminat Hypertoxic form dies within 24hrs of start.
Clinical features:symptoms
1st
day ●fever(low grade 37.
8-39ºc)●malaise ●fatigue ●sore throat(3 to 4 days continue and then decrease
.
Toxins have analgesic effect and this reduces the pain).
●dysphagia
2nd
day symptoms: ●hoarseness b/c of laryngeal involvement ●some grayish membrane on tonsils● edema of
neck(sometimes bull neck)●cervical lympadenopathy.
●hyperemia of throat ●enlarged tonsils covered by greyish
membrane(bilateral)●dyspnoea.
Diagnosis:
●history of contact with diphtheria patient,
●clinical features
●culture of nasal tonsillar swab material in loeffler medium.
●serological IgM↑.
IgG↑.
(bacteria can not be found in the blood).
●culture must be done b/f antibiotic therapy.
after therapy have to do culture to check whether microorganism are
present or not
●in serum >1:40(AG:AB)-healthy.
If < then sick ,if titer is negative then sick.
Complications: patient can die due to complications.
●myocarditis(onset at 1-3 wks)
●polyneuritis(onset after 2-4 wks)
●peripheral neuritis(start b/w 1-3 months)
●toxic nephritis(start in 1wk)
●respiratory symptoms-obstruction of respiratory tract due to pseudo membrane ,causing stenosis and neck
edema.
occurs during 1st
wk with symptoms of dyspnoea, tachypnea, cyanosis ,use of accessory muscles for
respiration-treatment is by hyper baric oxygenation and sometimes tracheostomy.
[Less]
Insert a miniCalaméo on your website or your blog
