Diptheria

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1
Diseas Classification
Diptheria
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Causative Agent
Corynebacterium diptheriae (+ phage toxin)
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Classification of CA
Gram-positive rod, aerobic, nonmotile, abundant fimbiae, produces diptheria exotoxin
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Epidemiology: Reservoir
Humans
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Epidemiology: POE
Respiratory Tract
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Epidemiology: MOT
Aerosol respiratory droplets, contact with contaminated body fluids
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Incubation Period
2-5 days
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Pathogenesis
Bacteria colonize upper respiratory tract and form a pseudomembrane that can obstruct the airway. They also secrete exotoxins that enter the bloodstream and inhibit protien synthesis in cells of the heart, kidneys, and nervous tissue resulting in paralysis and organ damage
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Symptoms
Adherent psuedomembrane, fever, bleeding, sore throat and difficulty swallowing, difficulty breathing, swollen lymph nodes, perceptible sweet smell, paralysis (first swallowing muscle), change to heart rhythem
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Diphtheria Toxin
Protien- 535 amino acid, A-B Toxin, Lethal Dose = 100ng/kg body weight
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A toxin attaches to
EF2 inhibitor
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B toxin binds to
receptor
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Complications
Blocking of the airway, damage to the heart muscle (myocarditis), nerve damage (polyneuropathy), kidney damage, paralysis, lung infection, current mortality rate 5-10% (up to 20% in individuals <5yrs and >40 yrs)
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Prevention
Vaccination- 1923 toxoid vaccine. created by heat and formaldehyde denaturation; current vaccines DTap, Tdap, DT, and Td
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Treatment
Antiserum (immunoglobulins)- Antitoxin therapy 1901, diphtheria antitoxin (DAT); Antibiotics- Penicillin, Erythromycine
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