What are the signs and symptoms of diphtheria (Corynebacterium diphtheriae infection)?

From the Guidelines

Diphtheria is characterized by a gray-colored pseudomembrane that is firmly adherent to the mucosa lining the nasopharynx, tonsils, or larynx, and its signs and symptoms include sore throat, difficulty swallowing, swollen neck glands, fever, weakness, and difficulty breathing. The main signs and symptoms of diphtheria include:

• Sore throat and difficulty swallowing
• Swollen neck glands (bull neck appearance)
• Thick gray membrane covering the throat and tonsils
• Fever, usually 101-102°F (38.3-38.9°C)
• Weakness and fatigue
• Hoarseness or loss of voice
• Difficulty breathing or rapid breathing In severe cases, diphtheria can also cause:
• Myocarditis (heart inflammation)
• Nerve damage leading to paralysis
• Kidney failure It's crucial to seek immediate medical attention if diphtheria is suspected, as it can be life-threatening, as noted in the study by 1. Diagnosis is typically made through throat swabs and cultures. Treatment involves antibiotics (usually penicillin or erythromycin) and diphtheria antitoxin, as recommended by 1. Patients are usually isolated until they are no longer contagious. The severity of symptoms relates to the toxin produced by the Corynebacterium diphtheriae bacteria, which can spread through the bloodstream, damaging other organs beyond the initial infection site in the respiratory tract, as described in the study by 1. Early recognition and treatment are vital to prevent complications and reduce mortality risk. Vaccination remains the most effective prevention method, typically given as part of the DTaP (diphtheria, tetanus, pertussis) vaccine series in childhood, with boosters recommended throughout life, as emphasized by 1 and 1.

From the Research

Signs and Symptoms of Diphtheria

The signs and symptoms of diphtheria (Corynebacterium diphtheriae infection) include:

• Sore throat and fever, often resulting in breathing difficulties, heart rhythm problems, and rarely membranous pharyngitis 2
• Upper respiratory tract infection, cutaneous infection, or asymptomatic carrier state 3
• Common clinical manifestations such as sore throat, malaise, cervical lymphadenopathy, and low-grade fever 3
• Absorption and dissemination of C. diphtheriae from the respiratory tract can cause disseminated infection and may lead to cardiac or neurological toxicity 3
• A gray, leathery membrane on the soft palate, tonsils, or other areas of the respiratory tract 4, 5
• Symptoms such as fever, severe throat pain, odynophagia, dysphagia, neck pain, and neck swelling 4
• Dirty white patch covering one or both tonsils, throat swabs collected for Kleb's-Loeffler's Bacillus (KLB) by direct microscopy and for culture and sensitivity of the organism 6

Clinical Diagnosis and Complications

• Clinical diagnosis of diphtheria is often made based on symptoms and physical examination, with laboratory tests such as throat swabs and culture used to confirm the diagnosis 6
• Complications of diphtheria can include cardiac or neurological toxicity, and the percentage of complications is high in patients with either KLB smear or culture or both positive 6
• The negative report of KLB smear and culture does not rule out diphtheria, and the correlation between clinical diagnosis and laboratory results is significant (p < 0.001) 6