Symptoms of diphtheria

Symptoms of diphtheria are diverse, depending on the form of the disease, but the common characteristic of diphtheria is inflammation, which provokes the appearance of a specific fibrinous membrane, film and strong edema in the zone of the inflammatory process.

Diphtheria, the symptoms of which were known as far back as the first century BC, was not accidentally called "sucker disease" from ancient times, and for a long time was considered a deadly disease, as the number of deaths was more than 80% of the total number of patients with this infection. Two centuries ago the disease was given a name that characterizes the main sign of diphtheria - from the Greek word diphtheri, that is, "film". Mass vaccinations began only in the second half of the last century, and only then the mortality rate from diphtheria dropped significantly. The causative agent of the disease is a specific toxin, Klebs-Leffler's wand, which affects various organs and systems of the human body, most often child's. Diphtheria can be in the zone of the nose, skin, throat, eyes, it can affect even the heart, nervous system and kidneys. The incubation period with this disease, as a rule, does not exceed seven days. Diphtheria, the symptoms of which depend on the zone of localization of the process, a very serious disease of bacterial etiology, divided into the following species and forms: 

• Infection of the oropharynx - localized, medium-heavy or common, sub-toxic, toxic in two stages and hypertoxic - deadly. 
• Croup - infection of the larynx, diphtheria of the trachea and larynx (common cereal), infection of the larynx, trachea with spread to the bronchi (descending diphtheria). 
• Diphtheria of the nasopharynx, nose. 
• Diphtheria infection of the genitals. 
• Ophthalmic diphtheria (eyes). 
• Diphtheria of the skin. 
• Simultaneous infection of organs is a combined diphtheria infection.

[1], [2]

Diphtheria, the symptoms of which indicate infection of the mouth (pharynx) - oropharynx

This is the most common form of the disease, which is divided into the following forms: 

[3], [4], [5], [6], [7], [8]

Localized form (typical, atypical)

This is the easiest variant of the course of the disease, characterized by catarrhal flow (atypical) and accompanied by a headache, painful sensations when swallowing food and liquids, a slight increase in temperature. Diphtheria membrane covers only tonsils, it is difficult to separate from them, it can grow again, which is the main clinical manifestation of the disease. Inflamed at once both tonsils, which are clearly hyperemic, rapidly swelling. Diagnostically the film is differentiated at the first stage with the help of simple manipulations - grinding and immersion in water. The film is not subject to grinding and quickly submerges on the bottom of the container with water. In bacterial studies, a specific exotoxin rod is isolated from the film. At palpation, the area of the lymph nodes is enlarged, recalls the painful sensations on the part of the patient. As a rule, this type of diphtheria is diagnosed only with preventive examination and with the help of serological, bacterial analysis, since localized diphtheria in mild form is rarely manifested by noticeable clinical symptoms. If localized diphtheria, the symptoms of which are hidden, is not treated, then it quickly enough transforms into a common or toxic) form. 

Toxic form (typical, atypical)

This is one of the most difficult variants of the course of the disease, which can develop independently, but can be a consequence of an untreated localized form of diphtheria. The toxic form of the disease is rapidly spreading, causing an increase in body temperature to 40 degrees. Pain is present in the throat and in the neck as a whole. Often this form is accompanied by delusions, delirium, vomiting. Toxic diphtheria, the symptoms of which appear very quickly, require immediate medical attention, since delay in the literal sense of the word is similar to death from suffocation. Swiftly developing laryngeal edema, hyperemia are able to completely block the lumen of the pharynx. Fibrinous film grows in a matter of hours, closing the pharynx, lymph nodes considerably increase in size, with palpation very painful. Often, puffiness spreads to the entire neck, reaching the collarbone, touching the face, the upper back. Diphtheria of this form in addition to edema and the risk of suffocation is marked by strong intoxication of the whole body, a sharp drop in blood pressure. The prognosis of treatment and the possibility of recovery depends on the time of going to the doctor and the beginning of emergency medical care. If toxic diphtheria is not controlled by resuscitation, it quickly passes into the hypertoxic stage, when encephalopathy is rapidly developing, the pressure drops to the lowest levels, the disseminated intravascular coagulation-DVS syndrome develops, resulting in toxic shock and death. 

Diphtheria, sipmtomy which indicate a common form, is considered a moderate variant of the course of the disease. The film captures not only the tonsils, but also the sky, the pharyngeal mucosa. Edema develops rapidly, but not to the same extent as in a toxic form. The pain in the oropharynx is moderate, the temperature rarely rises above 38 degrees. Plaque, film is amenable to neutralization and treatment within 10 days. Also, the common form of diphtheria does not have pathologically dangerous complications. 

Croup. Diphtheria, the symptoms of which indicate a croupous character

Diseases, which can be localized in the larynx, can also be in a common form, when the mouth, nose, trachea, and bronchi are affected simultaneously. Signs of groats are changes in the timbre of the voice (hoarse voice), a typical "barking" cough that gradually becomes silent. Breathing is difficult, with inhalation and exhalation noises are heard, the face becomes pale, and signs of cyanosis (blueing) are often visible. Cardiological signs - a strong tachycardia, an arrhythmia, a dyspnea or short wind can develop promptly and quite often leads to an asphyxia. With suffocation, blood pressure drops sharply, the pulse weakens, a person loses consciousness and without dying, can die. Especially dangerous is the croupous form of diphtheria in children, because their chest is less developed anatomically than adults, and choking occurs more quickly. 

Diphtheria infection of the nose is characterized by purulent discharge (catarrhal form), when breathing is disrupted due to nasal congestion with a diphtheria film. The mucous membrane is edematic, often covered with small ulcers, fibrinous films. Diphtheria, whose sigmtomas indicate a similar form of the disease, rarely is independent, most often it is combined with infection of the pharynx, larynx and eyes. 

Diphtheria symptoms may have localized in the eye area. Diphtheria eye damage also occurs in the catarrhal form, may be accompanied by intoxication or be in a film form. Most often in diphtheria of the eye, clinical signs of the disease are conjunctivitis, accompanied by periodic discharge in the form of mucus. The temperature rarely rises above 37 degrees, the lymph nodes are not enlarged, not inflamed. If the eyes are affected by diphtheria in a filmy form, the eyes swell and become covered with a loose fibrinous film. As a rule, first one eye is affected, after two or three days the process captures another. The toxic variant of the diphtheria of the eye develops more rapidly, the edema builds up within 24 hours, the purulent secret from the eyes is abundantly allocated. Puffiness spreads to the entire face, often grabbing the neck. 

Anal-genital diphtheria, the symptoms of which are often accompanied by signs of diphtheria of the pharynx and nose, is characterized by inflammation of the inguinal lymph nodes and total swelling. Genital organs are hyperemic, covered with a fibrinous film. In men, the foreskin is most often affected, in women - the vagina or anus. For all patients without this form of diphtheria, urination is difficult, there are serous, purulent discharge. Often the diphtheria of this form is combined with mycosis, which leads to erosions, cracks and purulent ulceration.

Diphtheria symptoms can be different, but there are common symptoms that allow you to diagnose the disease fairly quickly. Such signs include the following manifestations: 

• Sore throat, which has no explanation in the form of SARS or viral infection. 
• Difficulty breathing, shortness of breath, desire to throw back his head. 
• Increase in temperature from subfebrile to very high. 
• Weakness, nausea and vomiting. 
• Hyperemia of the oropharynx, turning into puffiness. 
• Increase in the size of tonsils 
• Changing the timbre of voice, hoarseness. 
• Clearly characteristic characteristic smell - sweetish-sour. 
• Painfully enlarged lymph nodes. 
• Puffiness in the neck. 
• Falling blood pressure, weakening heart rate. 
• Tachycardia, arrhythmia.

Diphtheria symptoms may also be latent, especially when there is a localized form of oropharyngeal disease, but this variant of the disease quickly develops into heavier, sometimes deadly forms of diphtheria. Therefore, the only effective method of preventing and reducing the risk of infection with diphtheria bacillus is to date an early vaccination, which is carried out every ten years until the age of 56 years.

[9], [10], [11], [12],