Diphtheria

*Diphtheria

*Corynebacterium diphtheriae + phage tox

*gram positive rod
*aerobic
*nonmotile
*abundant frimbiae
*produces diphtheria exotoxin

*humans

*respiratory tract

*aerosol respiratory droplets
*contact with contaminated body fluids

*bacteria colonize upper respiratory tract and form pseudomembrane (obstructs airway)
*secretes exotoxin (enter blood stream and inhibits protein synthesis in cells of heart, kidney, and nervous system)
*paralysis and organ damage

*protein 535 amino acids
*A-B toxin
*EF2 inhibitor

Adherent pseudomembrane
fever
bleeding
sore throat and difficulty swallowing
difficulty breathing
swollen lymph nodes
perceptible sweet smell
paralysis (with swalloing muscles)
change to heart rhythm (arrythemia)

*blocking of airway
*damage to heart muscle (myocarditis)
*nerve damage (polyneuropathy)
*kidney damage
*loss of ability to move (paralysis)
*lung infections (resp failure or pneumonia)

5-10%

*Vaccination (1923 toxoid vaccine)
DTap, Tdap, DT, Td

*every 10 years

*antiserum (immunoglobulins)
>antitoxin therapy
>diptheria antitoxin (DAT)
>Antibiotics (PCN and erythromycine)

*phage toxin
bacteria without phage toxin isn't toxic

When phage is there

abundance of fimbriae to attatch

AB toxin (B part gains entry, A affects inside cell)

*inhibits protein synthesis
causes paralysis (affects nervous system)

attatches to EF2 (elongation factor on ribosome) (prevents transcription in cell, cell can't survie/send signals)

white film almost thrush looking (adhesive) doesn't come off

*sweet smell

swallowing muscles then heart

psceudomembrane blocks airway

*contains the toxin (denatures proteins by cross linking) helps the body identify parts of toxin

*must ask CDC for specific drug (due to rariety)