| Disease |
DIPHTHERIA |
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| Quotation |
“.. in the physician or surgeon No quality takes rank wit imperturbability” |
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| Definition |
Acute respiratory tract infection caused by Cornybacterium Dipitheria, with formation of adherent gray membrane in the pharynx, nose and occasion extension to larynx, and production of an exotoxin that can cause cardac and neural damage. |
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| Prognosis |
In the non-immune there could mortality upto 10%. |
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| General Measures |
Bed rest is absolutely necessary for at least 3 weeks. Those with features of myocarditis need absolute rest until the features settle fully.Adequate hydration and nutrition should be ensured.Secretions should be suctioned.Tracheostomy might be required for laryngeal dipitheria, and should be resorted to early, as delaying until cyanosis has appeared might lead to cardiac arrest during manipulation of the tissues.Palatal and paharyngeal palsy will call for gastric lavage to avoid aspiration. |
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| Advice to Patient |
Should understand possible complications of illness. |
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| Follow Up |
ECG 2-3 times a week to detect myocarditis, early.Elimination of the organism should be ensured by 3 negative cultures 24 hours apart, the first being done a day after stopping antibiotic therapy. Only then should the patient be released from isolation. During convalescence the patient shoud be immunized against diphtheria, as infection does not confer immunity. |
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| Prevention |
All infants to immunized by monthly injections of toxoid, as part of DPT, starting 3 months.Booster doses at 1 year f age and again at 5years.Contact of cases should be immunized with a booster dose even if previously immnunised and given a course of antibiotics. The nonimmune contacts should get cultures done and given antibiotic prophylaxis with erythromycin for 7 days or pencilin IM. |
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| Reference From |
www.emedicin.com/EMERG/topic138.htm |
