Diphtheria Clinical

Diphtheria Clinical

Toshev Azizbek 202/1 ped

Diphtheria

is an infectious disease of the larynx and upper respiratory tract caused by the bacterium Corynebacterium diphtheriae (Leffler's bacillus, diphtheria bacillus), the characteristic features of which are the formation of characteristic "diphtheria" films on the surface of the mucous membranes, making it difficult to breathe, and severe intoxication.

ETIOLOGY

Diphtheria bacillus Corynebacterium diphtheriae was isolated in pure culture in 1884 by F. Loeffler and E. Klebs. Elongated straight rods are typical; atypical forms (cocco-like, clavate) are found. Living microbes are motionless, have no flagella, do not form spores. Gram positive.

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Sources of infection

• Sick person

• • Healthy carrier of bacteria

Transmission routes

• Airborne (when coughing, sneezing)

• Food grade (via contaminated foods)

• Through the wound surface (damaged skin)

• Contact and household (through household items)

Seasonality

• Аutumn-winter periodutumn-winter period

Receptive contingent

• Adults without anti-diphtheria immunity

• Children not vaccinated or with residual vaccine immunity

EPIDEMIOLOGY

SYMPTOMS

• Erased onset (difficult to determine when the onset of the disease) • Subfebrile temperature

• Pallor of the skin

• Severe weakness

• Swelling of the soft tissues of the neck ("bull's neck")

• Mild sore throat, difficulty swallowing

• Augmentation of the palatine tonsils

• Hyperemia and edema of the pharyngeal mucosa

• A membranous plaque (can be of any color, but most often it is gray-white) that covers the tonsils and sometimes spreads to the palatine arches, soft palate, lateral walls of the pharynx, larynx.

• Enlarged cervical lymph nodes

DIAGNOSTICS

In the case of the appearance of a characteristic fibrous plaque on the tonsils and in the nasal cavity, laboratory diagnostics are used to identify the diphtheria bacillus. The following analyzes are performed: • general blood test, indicating the presence of an acute inflammatory process; • bacterioscopy (a smear for diphtheria taken from the tonsils or from the nasal cavity is examined under a microscope); • bacteriological examination (the taken biomaterial is sown in a special nutrient medium, germinated and studied under a microscope); • antitoxic antibody titer; • serological study (specific antibodies in blood serum are determined).

TREATMENT

Diphtheria treatment is carried out only in a hospital setting. Hospitalization is compulsory for all patients, as well as for patients with suspected diphtheria and bacterial carriers. Antibiotics (penicillin or erythromycin) do not affect the lesions caused by exotoxin, but they limit further bacterial growth and the duration of carriage of the causative agent of diphtheria, which often continues even after clinical recovery. The main thing in the treatment of all forms of diphtheria (except for the carrier of bacteria) is the administration of antitoxic antidiphtheria serum (PDS), which suppresses diphtheria toxin. The dose of antidiphtheria serum is determined by the severity of the disease.

According to localization and toxicity, the following forms are

distinguished:

• oropharyngeal diphtheria (frequency - 92%):
• localized - catarrhal, island and film;
• common - plaque goes beyond the oropharynx;
• subtoxic, toxic (3rd degree of toxicity), hypertoxic, hemorrhagic;
• diphtheria croup (frequency - 1.3%):
• localized, manifested by inflammation of the larynx;
• common - inflammation goes beyond the larynx and captures the trachea;
• descending - in addition to the larynx and trachea, there is damage to the bronchi;
• diphtheria of other organs (eyes, ears, nose, genitals, skin; frequency - 0.5%).
• combined form - simultaneous damage to several organs.

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