A36.2

Clinical Causes: Infection with the bacteria Corynebacterium diphtheriae Transmission through respiratory droplets from coughing or sneezing of an infected person Contact with contaminated objects or surfaces carrying the bacteria poor vaccination coverage or waning immunity

Key Symptoms: Sore throat and difficulty swallowing Hoarseness or loss of voice Fever and chills Difficulty breathing or noisy breathing Fatigue and weakness A characteristic thick gray or white membrane covering the tonsils, pharynx, and larynx Swelling in the neck area due to lymphadenopathy (enlarged lymph nodes)

Diagnosis Path: Diagnosis of laryngeal diphtheria involves a combination of clinical evaluation and laboratory tests. Physicians typically examine the throat for characteristic membrane formation, swelling, and other signs of infection. Laboratory confirmation is achieved through throat swabs or tissue samples, which are cultured to identify Corynebacterium diphtheriae. Additional tests, such as cytological examinations or PCR (polymerase chain reaction), may be used to detect bacterial DNA, especially in atypical cases, to ensure accurate diagnosis.

Treatment Protocols: Treatment aims to eliminate the bacteria, neutralize the toxin, and manage airway complications. The main approaches include: - **Antitoxin therapy**: Administered as soon as diphtheria is suspected to neutralize circulating toxins (usually derived from horse serum). It is critical to start treatment promptly to prevent severe complications. - **Antibiotics**: Such as erythromycin or penicillin, used to eradicate bacterial infection and prevent transmission to others. - **Airway management**: In cases with significant airway obstruction, procedures like intubation or tracheostomy may be necessary to ensure adequate breathing. - **Supportive care**: Including hydration, fever management, and addressing any secondary infections. Vaccination remains the most effective prevention method. The diphtheria vaccine, often combined with tetanus and pertussis vaccines, is recommended for children and adults to protect against infection. Booster doses are essential as immunity wanes over time.