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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Article Home Children's Health Diphtheria in children

Diphtheria in children

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Diphtheria is a serious bacterial infection, usually affecting the mucous membranes of nose and throat. Diphtheria typically causes a bad sore throat, fever, swollen glands and weakness. But the hallmark sign is a thick, gray covering in the back of throat that can make breathing difficult. Diphtheria can also infect your skin.

Diphtheria

Why do you get diphtheria?

The disease is mainly transmitted by:

  • Droplets from the nose or throat being passed from person to person, egg by coughing or sneezing.
  • Contaminated personal items, such as tissues or drinking glasses that have been used by an infected person (occasionally)
  • Contaminated household items, such as towels or toys (rarely).

What are the symptoms of the disease?

The incubation period, which is the time that elapses between a person being infected and the disease developing, is usually two to five days.

Signs and symptoms of diphtheria may include:

  • A sore throat and hoarseness
  • Painful swallowing
  • Swollen glands (enlarged lymph nodes) in your neck
  • A thick, gray membrane covering your throat and tonsils
  • Difficulty breathing or rapid breathing
  • Nasal discharge
  • Fever and chills
  • Malaise.

Risk factors:

  • Children younger than 5 years old and adults older than 60 are particularly at risk of contracting diphtheria, as are:
  • Children and adults who don't have up-to-date immunizations
  • People living in crowded or unsanitary conditions
  • Undernourished people
  • People who have a compromised immune system

Skin (cutaneous) diphtheria: A second type of diphtheria can affect the skin. A wound infected with bacteria is typically red, painful and swollen. A wound infected with diphtheria-causing bacteria also may have patches of a sticky, gray material.

Diagnosis:

Throat swab and culture.

Complications:

  • Breathing problems: Diphtheria-causing bacteria may produce a poison (toxin). This toxin damages tissue in the immediate area of infection — the nose and throat, for example. This localized infection produces a tough, gray-colored membrane — which is composed of dead cells, bacteria and other substances — on the inside of your nose and throat. This tough membrane, or covering, is dangerous because it can obstruct breathing.
  • Heart damage: The diphtheria toxin may spread through your bloodstream and damage other tissues in your body, such as your heart muscle. One complication of diphtheria is inflammation of the heart muscle (myocarditis). Signs and symptoms of myocarditis include fever, vague chest pain, joint pain and an abnormally fast heart rate.
  • Kidney damage: The diphtheria toxin may damage the kidneys, affecting their ability to filter wastes from the blood.
  • Nerve damage: The toxin can also cause nerve damage, targeting certain nerves such as those to the throat, making swallowing difficult. Nerves to the arms and legs may also become inflamed, causing muscle weakness. In severe cases, nerves that help control the muscles used in breathing may be damaged, leading to paralysis of these muscles and trouble breathing.

Treatment:

  • Diphtheria anti toxin: The antitoxin neutralizes the diphtheria toxin already circulating in your body. The antitoxin is injected into a vein (intravenously) or into a muscle (intramuscular injection).
  • Antibiotics: Diphtheria is also treated with antibiotics, such as penicillin or erythromycin. Antibiotics help kill bacteria in the body, clearing up infections. Patients with allergies to penicillin G or erythromycin can use rifampacin or clindamycin.

Prevention:

Diphtheria vaccine is given in combination with pertussis and tetanus as DPT vaccine at 6, 10, 14 weeks.