Diagnosis of diphtheria in adults
Last reviewed: 23.04.2024
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Diagnosis of diphtheria, regardless of the localization of the process, is based on the presence on the mucous membranes or skin of a fibrinous film that has characteristic properties. When common and toxic. Forms of great diagnostic importance is the spread of plaques, the limits of the tonsils, edema of the tonsils, and in toxic forms - swelling of the soft tissues of the neck.
To confirm the diagnosis, microbiological examination of smears from the affected surface is important (mucous membrane of the tonsils, nose, etc.). After isolating the culture of the pathogen, its toxigenic and biological properties are determined.
[Indications for consultation of other specialists
If necessary, the following specialists are consulted:
- neurologist (paresis of cranial nerves, peripheral polyneuropathy);
- cardiologist (myocardial damage syndrome);
- resuscitator (respiratory disorders, multiple organ failure);
- otorhinolaryngologist (diphtheria of the larynx, diphtheria croup).
Indications for hospitalization
All patients with suspected diphtheria should be hospitalized and isolated.
Differential diagnosis of diphtheria
Differential diagnosis of diphtheria of the oropharynx is carried out with all diseases occurring with the syndrome of acute tonsillitis.
In practice, differential diagnostics between lacunar angina and localized diphtheria of the oropharynx is most difficult.
The main differential diagnostic criteria of diphtheria:
- for lacunar angina characterized by acute development of intoxication syndrome, with localized diphtheria of the oropharynx, intoxication is poorly expressed;
- with lacunar angina reveals a more pronounced reaction of tonsillar lymph nodes;
- fibrinous plaque on the tonsils is much more common in diphtheria;
- with angina, the pain in the throat is more intense, especially when swallowing;
- with angina, the mucous membrane of the oropharynx is clearly hyperemic, with a localized diphtheria of the oropharynx dull, with a gray or cyanotic hue;
- long lasting (3-8 days) plaque after normalization of health and body temperature are characteristic for localized diphtheria of the oropharynx.
In addition to streptococcal and staphylococcal angina, it should be borne in mind infectious mononucleosis, ulcerous necrotic angina of Simanovsky-Plaut-Vincent, anginous-bubonic tularemia, syphilitic sore throat, fungal oropharyngeal lesions.
In toxic diphtheria, differential diagnostics is performed with paratonsillar abscess, mumps, phlegmon of the phlegmon of the mouth of phlegmon Ludwig), chemical burns, necrotic sore throat with agranulocytosis and acute leukemia.
Differential diagnosis of respiratory tract diphtheria is carried out with croup in ARVI: catarrhal phenomena are characteristic, absence of aphonia. Adults often mistakenly diagnose bronchitis, pneumonia, asthmatic condition, foreign body in the larynx. A timely laryngoscopy is important.