diphtheria

Diphtheria: description

Diphtheria is an acute bacterial infection. It usually affects the upper respiratory tract, especially the pharyngeal mucosa.

The triggering bacteria are transmitted by coughing or sneezing from human to human (droplet infection). Once they settle in the pharyngeal mucosa, they begin to produce a poison (toxin). This poison is responsible for diphtheria symptoms such as sore throat and fever. It can also spread throughout the body and damage the heart and other vital organs. Doctors call this a toxic diphtheria. In such cases – and if the disease remains untreated – mortal danger may exist.

In Germany, there is a duty 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 affected.

With a diphtheria vaccine can prevent the disease. Since the vaccination was introduced in Germany, the number of new cases has fallen sharply. Nevertheless, local epidemics often occur, because people can not be vaccinated again and again.

Diphtheria: symptoms

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

The complaints usually start in the throat. The poison produced by the bacteria swells up the mucous membranes. It comes to Sore throat, difficulties swallowing, fever and one general malaise, The neck is usually visible from the outside swollen.

On the almonds form whitish-yellow coverings, They are called pseudomembranes and are a sure sign of diphtheria to the doctor. The pads can spread to the throat and nose. If you try to strip them, the mucous membrane begins to bleed underneath.

During the entire duration of the disease occurs sweetish-foul bad breath on.

It becomes dangerous when the disease spreads to the larynx. Here, too, the mucous membranes swell. This swelling leads first to a barking cough (the so-called Krupp cough) and too hoarseness, When the swelling increases, it can difficulty in breathing come. At this stage the disease is life threatening!

In rare cases, the bacterial poison spreads to the internal organs out. Symptoms such as cardiac arrhythmias, paralysis (when nerves are affected), pneumonia, kidney or liver failure can then result in death.

In children and infants, moreover, the nasal mucosa is often affected. In such cases, a bloody or purulent occurs Discharge from the nose on.

In the initial stage, diphtheria may be confused with tonsillitis, laryngitis or pseudo-Krupp.

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 takes place from person to person, usually in the form of a droplet infection (coughing, sneezing). Even before the onset of the first symptoms of diphtheria, those affected are contagious, so they can pass on the pathogen to other people.

Diphtheria: examinations and diagnosis

Diphtheria distinguishes between the suspected diagnosis and the actual diagnosis:

The diagnosis represents the doctor on the basis of the symptoms.

For the actual, safe diagnosis the diphtheria bacterium must be detected. For this, the doctor takes a swab of the throat or nasal mucosa with a cotton swab. This smear is examined in the laboratory for the pathogen and its poison. However, the results are available only after twelve hours. Therefore, the doctor often begins with the suspected diphtheria therapy.

Diphtheria: treatment

The patient receives an antidote to the diphtheria toxin (Diphtheria antitoxin). This neutralizes the toxin, which is free in the body, and makes it harmless. However, the antidote can do nothing against the toxin that is already bound to body cells.

With antibiotics the diphtheria bacterium is directly controlled. The antibiotics usually take place over ten days. The aim is to stop the multiplication and poison production of the pathogen. The most widely used antibiotic is penicillin.

Another important treatment is bed rest over at least four weeks.

Immediately after the diagnosis become affected isolatedSo they are quarantined. Only people who have sufficient vaccine protection may then come into contact with patients.

All persons who had been in contact with the patient before quarantine were also examined for diphtheria. In most cases you will receive a precautionary antibiotic (prophylaxis). In non-vaccinated contact persons, the vaccination is made up immediately.

Diphtheria immunization

With a diphtheria vaccine can prevent the disease. Read more 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, there is a good prognosis, and patients can usually be completely cured.

However, the disease can also cause various complications that also affect the prognosis. For example, in severe cases, patients may die from heart failure or suffocation.

In general, about five to ten percent of all those affected die from diphtheria infection. In countries where medical care is good, mortality is lower. In areas with poor medical care, such as many developing countries, the mortality rate is at diphtheria on the other hand, considerably higher.