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Diphtheria esophagitis
Last reviewed: 04.07.2025
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Diphtheritic esophagitis occurs with an erased clinical picture and, as a rule, remains unnoticed against the background of pronounced symptoms of diphtheria of the pharynx or larynx.
Esophageal damage by diphtheria infection is a rare disease. It can occur in severe cases of pharyngeal diphtheria with spread to the hypopharynx and esophagus. Usually, the upper sections of the esophagus are affected, but there are cases of damage to its lower third and even the gastric mucosa.
[ Symptoms of diphtheria esophagitis
With a slow development of the disease, diphtheritic esophagitis may manifest itself with sudden vomiting during meals and the presence of dirty-gray diphtheritic films with an unpleasant odor, covered with streaks of blood in the vomit. At the same time, pain in the esophagus and a worsening of the general condition of the patient occur.
During fibroesophagoscopy, the walls of the esophagus are covered with dark-gray or yellowish deposits, tightly fused with the underlying tissue, bleeding when separated; ulcerated and necrotic surfaces of the walls are determined in places. Klebs-Leffler rods are detected in the removed films.
The evolution of diphtheria esophagitis depends less on the damage to the esophagus than on the severity of the general diphtheria infection.
Complications arise in the form of paralysis of the esophagus and its strictures. Usually, cicatricial stenosis of the esophagus, caused, for example, by a chemical burn, is localized above physiological constrictions; in diphtheritic esophagitis, they usually arise in the places of these constrictions and at its ends - the upper and lower.
There are early and late post-diphtheria esophageal strictures. Early ones occur 3 weeks after the onset of the disease and are not characterized by pronounced obstruction (it is possible for liquid or mushy food to pass through the strictures). Late strictures cause a significant narrowing of the esophageal lumen, sometimes not exceeding 1-3 mm, extending in length by 1-3 cm.
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Diagnosis of diphtheritic esophagitis
Diagnosis of both diphtheritic esophagitis itself and its consequences in the form of paralysis and strictures is quite difficult. Usually the former are established indirectly by the presence of neuritic paralysis of the soft palate and hypopharyngeal muscles, stenosis - by the characteristic clinical picture of esophageal obstruction and esophagoscopy data of X-ray examination.
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What tests are needed?
Who to contact?
Treatment of diphtheria esophagitis
Treatment of diphtheritic esophagitis is included in the general treatment of diphtheria infection - serotherapy, penicillin therapy, stimulation of the functions of vital organs, painkillers, sedatives; a gentle liquid diet, cooled mucous decoctions with a suspension of penicillin; monitoring of kidney function, in diphtheritic polyneuritis - preparations of vitamins of group B, etc. In case of cicatricial stenosis of the esophagus and the impossibility of natural nutrition, gastrostomy and bougienage of the esophagus are performed to expand its stricture.