II. Epidemiology

  1. Rare in United States due to Immunization (DTP, DTaP)
    1. However 20% of adults may be inadequate immune status
  2. Ongoing epidemic in the former USSR

III. Etiology

  1. Corynebacterium diphtheriae

IV. Symptoms

  1. Sore Throat
  2. Dysphagia
  3. Weakness
  4. Malaise

V. Signs

  1. Toxic appearance
  2. Fever
  3. Tachycardia (out of proportion to fever)
  4. Pharyngeal erythema
  5. Gray-white tenacious exudate or "membrane"
    1. Occurs at tonsillar pillars and posterior pharynx
    2. Leaves focal hemorrhagic raw surface when removed
  6. Cervical Lymphadenopathy

VI. Differential Diagnosis

  1. Vincent's Angina (Trench Mouth)
    1. Also shows pseudomembrane formation
  2. Pharyngitis

VII. Labs

  1. Complete Blood Count (CBC)
    1. Leukocytosis
  2. Throat Culture
    1. Positive for Corynebacterium organisms

VIII. Management

  1. Diphtheria antitoxin
  2. Erythromycin 20-25 mg/kg q12 hours IV for 7-14 days

IX. Prevention

  1. DTP vaccination or DTaP vaccination

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Ontology: Corynebacterium diphtheriae (C0010150)

Definition (NCI_CDISC) Any bacterial organism that can be assigned to the species Corynebacterium diphtheriae.
Definition (NCI) A species of aerobic or facultatively anaerobic, Gram-positive, coryneform, pleomorphic bacilli assigned to the phylum Actinobacteria. This species is nonmotile, non-spore forming, catalase positive, non-lipophilic, produces diphtheria toxin which inhibits elongation factor 2 (EF-2) thus preventing protein synthesis, forms polar granules, and is cultured in Loeffler's serum in a low iron environment or on tellurite agar. C diphtheriae is commensal in the skin and nasopharynx, but toxin producing strains are pathogenic to humans causing diphtheria; both an antitoxin and vaccine are available for disease prevention.
Definition (MSH) A species of gram-positive, asporogenous bacteria in which three cultural types are recognized. These types (gravis, intermedius, and mitis) were originally given in accordance with the clinical severity of the cases from which the different strains were most frequently isolated. This species is the causative agent of DIPHTHERIA.
Definition (CSP) species of gram positive, asporogenous bacteria in which three cultural types are recognized; these types (gravis, intermedius, and mitis) were originally given in accordance with the clinical severity of the cases from which the different strains were most frequently isolated; the causative agent of diphtheria.
Concepts Bacterium (T007)
MSH D003353
SnomedCT 5851001
LNC LP16683-2, MTHU006922
English Corynebacterium Diphtheriae, CORYNEBACT DIPHTHERIAE, C. diphtheriae, Corynebacterium diphtheriae (Kruse 1886) Lehmann and Neumann 1896, Bacillus diphtheriae, Bacterium diphtheriae, Microsporon diphthericum, Microsporon diphtheriticum, Mycobacterium diphtheriae, Pacinia loeffleri, CORYNEBACTERIUM DIPHTHERIAE, Diphtheria bacillus, Klebs-Loeffler bacillus, Corynebacterium diphtheriae (organism), Corynebacterium diphtheriae
Swedish Corynebacterium diphtheriae
Czech Corynebacterium diphtheriae
Finnish Corynebacterium diphtheriae
Russian KORINEBAKTERII DIFTERII, PALOCHKA LEFLERA, CORYNEBACTERIUM DIPHTHERIAE, BACILLUS DIPHTHERIAE, BACTERIUM DIPHTHERIAE, MICROSPORON DIPHTHERICUM, PACINIA LOEFFLERI, КОРИНЕБАКТЕРИИ ДИФТЕРИИ, ПАЛОЧКА ЛЕФЛЕРА
Polish Corynebacterium diphtheriae, Maczugowce błonicy
Norwegian Corynebacterium diphtheriae
Spanish Corynebacterium diphteriae, Bacilo diftérico, Corynebacterium diphtheriae (organismo), bacilo de Klebs - Loeffler, Corynebacterium diphtheriae
French Bacille diphtérique, Corynebacterium diphtheriae
German Bacterium diphtheriae, Corynebacterium diphtheriae, Diphtherie-Bakterium
Italian Corynebacterium diphtheriae
Dutch Corynebacterium diphtheriae
Portuguese Corynebacterium diphtheriae

Ontology: Diphtheria (C0012546)

Definition (MEDLINEPLUS)

Diphtheria is a serious bacterial infection. You can catch it from a person who has the infection and coughs or sneezes. It usually affects the nose and throat and causes a bad sore throat, swollen glands, fever, and chills. But if it is not properly diagnosed and treated it produces a poison in the body that can cause serious complications such as heart failure or paralysis.

The diphtheria, pertussis and tetanus (DPT) vaccine can prevent diphtheria, but its protection does not last forever. Adults should get another dose, or booster, every 10 years. Diphtheria is very rare in the United States because of the vaccine.

Centers for Disease Control and Prevention

Definition (NCI) A Gram-positive bacterial infection caused by Corynebacterium diphtheria. It usually involves the oral cavity, pharynx, and nasal cavity. Patients develop pseudomembranes in the affected areas and manifest signs and symptoms of an upper respiratory infection. The diphtheria toxin may cause myocarditis, polyneuritis, and other systemic effects.
Definition (MSH) A localized infection of mucous membranes or skin caused by toxigenic strains of CORYNEBACTERIUM DIPHTHERIAE. It is characterized by the presence of a pseudomembrane at the site of infection. DIPHTHERIA TOXIN, produced by C. diphtheriae, can cause myocarditis, polyneuritis, and other systemic toxic effects.
Definition (CSP) localized infection of mucous membranes or skin caused by toxigenic strains of Corynebacterium diphtheriae; it is characterized by the presence of a pseudomembrane at the site of infection; diphtheria toxin, produced by C. diphtheriae, can cause myocarditis, polyneuritis, and other systemic toxic effects.
Concepts Disease or Syndrome (T047)
MSH D004165
ICD9 032.9, 032
ICD10 A36 , A36.9
SnomedCT 154299004, 186349009, 187323007, 3739008, 397428000, 276197005
LNC LA10452-3
English Diphtheria, Diphtherias, Diphtheria, unspecified, [X]Diphtheria, unspecified, diphtheria, diphtheria (diagnosis), Diphtheria NOS, Diphtheria [Disease/Finding], Diphtheria NOS (disorder), Corynebacterium diphtheriae infection, [X]Diphtheria, unspecified (disorder), Infection due to Corynebacterium diphtheriae, Diphtheria (disorder), Infection due to Corynebacterium diphtheriae (disorder), diphtherial; infection, infection; Corynebacterium diphtheriae, infection; diphtherial, Corynebacterium diphtheriae; infection, Diphtheria, NOS
Dutch difterie, niet-gespecificeerd, Corynebacterium diphtheriae-infectie, Corynebacterium diphtheriae; infectie, difterisch; infectie, infectie; Corynebacterium diphtheriae, infectie; difterisch, Difterie, niet gespecificeerd, difterie, Difterie
French Diphtérie, non précisée, Infection à Corynebacterium diphtheriae, Diphtérie
German Diphtherie, unspezifisch, Corynebacterium diphtheriae-Infektion, Diphtherie, nicht naeher bezeichnet, Diphtherie
Italian Infezione da Corynebacterium diphtheriae, Difterite non specificata, Difterite
Portuguese Difteria NE, Infecção por Corynebacterium diphtheriae, Difteria
Spanish Infección por Corynebacterium diphtheriae, Difteria no especificada, [X]difteria, no especificada, [X]difteria, no especificada (trastorno), difteria, SAI, infección por Corynebacterium diphteriae, difteria, SAI (trastorno), difteria, difteria (trastorno), infección por Corynebacterium diphtheriae (trastorno), infección por Corynebacterium diphtheriae, Difteria
Japanese ジフテリア、詳細不明, ジフテリア, コリネバクテリウム・ジフテリア感染, ジフテリアショウサイフメイ, コリネバクテリウムジフテリアカンセン, ジフテリア
Swedish Difteri
Czech záškrt, Infekce způsobená Corynebacterium diphteriae, Difterie, Difterie, blíže neurčená, difterie, diftérie, mázdřivka
Finnish Kurkkumätä
Russian DIFTERIIA, ДИФТЕРИЯ
Korean 디프테리아, 상세불명의 디프테리아
Polish Dyfteryt, Błonica, Zakażenie Corynebacterium diphtheriae
Hungarian diphtheria, nem meghatározott, diphtheria, Corynebacterium diphtheriae fertőzés
Norwegian Difteri