Diphtheria: symptoms, treatment and prevention of the causes of diphtheria

Overview

Diphtheria has been known since ancient times, it is mentioned in the writings of Hippocrates, Galen. Old name - cereals, malignant angina, Diphtheria. We will try to tell you about the symptoms, treatment and prevention of diphtheria.

Success in the treatment of diphtheria is associated with the release of serum antitoxin been ill animals - an antidote to exotoxin diphtheria bacilli. Through hard work Emile Roux and Emil Behring created antitoxic diphtheria serum. With its help the symptoms of diphtheria mortality was reduced from 60-70% to 1-2%.

Today vaccine is used for preventionDeveloped by Gaston Ramon, a disciple Roux.

Causes

Reason diphtheria - diphtheria bacillus, gram-positive bacterium. It highlights exotoxin, which refers to a potent bacterial poisons (along with the botulinum toxin and tetanus toxin).

It consists of several components:

• hyaluronidase (Enzyme) - destroying the cell wall of the capillary, hence high vascular permeability, the deposition of protein in the surrounding tissues of fibrinogen from blood serum.
• Nekrotoksin - destroys epithelial cells; It is allocated thrombokinase which promotes the synthesis of fibrin from fibrinogen (characteristic of the film).
• The main toxin - inhibits cell respiration and the synthesis of protein molecules. Its effect is especially pronounced in small vessels, nerve cells and myocardium. Disease severity is determined by the action of this toxin.

mechanism of infection - from the ailing person or healthy, which is a carrier of infection. Especially dangerous in the spread of this disease, patients with erased symptoms of the disease or atypical of its course.

Transmitted disease in three ways:

• droplets (during conversation, by coughing);
• contact-household;
• Food (via contaminated foods).

Diphtheria bacteria secrete for 15-20 days, and in case of recovery - up to 3 months.

Classification

The disease varies in form, it is isolated, such flavors:

• Diphtheria oropharynx. In turn, divided into:
  • localized;
  • common;
  • sub-toxic;
  • toxic;
  • hypertoxic.
• Diphtheria croup.
• Other locations - the eyes, nose, genitals, skin.
• Combined.

The first of these is diagnosed in 90-95% of all cases and is considered to be the most common.

symptoms of diphtheria

Classical diphtheria (oropharynx) is characterized by:

• rise in temperature (usually not above 38 ° C);
• general intoxication (anorexia, heart palpitations, weakness, headache, pale skin);
• a touch on the affected mucosa: first, he is white and fluffy, and then - a grayish-white, dense and smooth;
• moderate or severe pain in the throat when swallowing movements;
• increasing sensitivity and regional lymph nodes;
• swelling of the neck.

Depending on the degree of toxic damage, general condition and concomitant disease severity intoxication varies.

When diphtheria croup affected mucous larynx, trachea or bronchi. It characterized by the following symptoms:

• cough (dry, like a "barking");
• increasing hoarseness;
• progressive aphonia (loss of voice sonority);
• shortness of breath with a characteristic noise, even asphyxia possible.

diphtheria of the nose It has a more mild symptoms. An increase in temperature is absent or is it slightly, the overall toxicity is weak. Difficulty breathing through the nose, it is covered with mucous ulcers and characteristic touch.

diphtheria eye similar to the classic conjunctivitisOn the inflamed areas can form plaque - a secret allocated serous-purulent character.

Diphtheria genitals manifested by edema and hyperemia of the foreskin and the glans penis (in men), labia and vagina (in women). Forms characteristic fibrinous plaque in women observed hemorrhagic discharge.

Skin infected in case of violation of their integrity. Diphtheria bacillus "survives" on the scratches, wounds, injuries of fungal origin. Diphtheria skin is also accompanied by fibrinous typical coating.

diagnosis of diphtheria

The complex of diagnostic measures:

• examination and medical history of the patient;
• complete blood count (in the presence and intensity of inflammation);
• smear inflamed mucous (throat, nose, eyes and so on.) followed bakposeve;
• PCR diagnostics as auxiliary method, specifying the number of antitoxic antibodies.

In severe intoxication, developing complications shown consultation neurology, cardiology, and specific examination, e.g., ultrasound of the heart, the ECG.

diphtheria treatment

Diphtheria Treatment is recommended to be carried out in specialized medical institutions, as a rule, infectious wards. The main therapeutic measure - the introduction of antitoxic diphtheria serum. The earlier you start its introduction, the better.

In addition to the treatment prescribed:

• detoxification solutions;
• antihistamines;
• vitamin complexes;
• antibiotics (to prevent secondary bacterial infections).

When toxic and hypertoxic forms of the disease it is advisable to make plasmapheresis, discusses the use of hemosorption, immunoadsorption. Appointed by the hormonal drugs in order to eliminate adrenal insufficiency.

Showing frequent airing and wet cleaning of the premises where the patient, steam inhalation, warm drink.

When hypoxia prescribe oxygen therapy. Respiratory failure, tachypnea more than 40 times per minute are indications for tracheal intubation or tracheostomy ventilator followed.

Prevention of diphtheria

The main preventive measure against diphtheria - vaccination. The first inoculation (three times in 1 month intervals introduction of the vaccine) are recommended starting at the age of three. In this case, the natural extinction of innate immunity received from the mother, in the 6 months the body will already be prepared for the meeting with the diphtheria bacillus. Revaccination performed at 6, 11 and 16 years.

When 97-98% of vaccinated children the disease is not recorded or observed it isolated cases.

Actual booster vaccination for adults, especially if they are - workers:

• Schools and pre-schools;
• Service sector;
• medicine;
• Universities (here is included and students, especially those living in hostels).

Upon confirmation of the diagnosis carried out these preventive measures:

• Hospitalization and isolation.
• Identifying media diphtheria bacilli in the patient's environment.
• Disinfection things sick and wet cleaning with antiseptics.

Forecast

Mild to moderate for localized diphtheria gives positive outlook. Heavy flows toxic form, especially with the joined secondary infections, failure to notice symptoms of late begun treatment of diphtheria develop complications of the respiratory system, heart, kidneys and nervous system. The lethal outcome is still possible, though unlikely. Today, they end up 5% of all cases.

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