Diphtheria Symptoms: Signs of This Respiratory Disease

Diphtheria Symptoms: Early Signs of This Respiratory Disease & Treatment

Diphtheria symptoms typically include the formation of a thick, grey or white membrane covering your throat and tonsils. It can cause individuals to have difficulties with swallowing food or breathing. Antibiotics treat diphtheria effectively but can also lead to serious, life-threatening conditions. Apart from this, vaccination at an early age can prevent the infection.

Diphtheria is a serious, potentially life-threatening bacterial infection that primarily affects the respiratory system but can also infect the skin. It is caused by the bacterium Corynebacterium diphtheriae. This is prevalent among school-going children and adolescent kids.

In this blog, we will highlight some common diphtheria symptoms, along with certain diagnostic tests for this respiratory condition. Additionally, we will discuss specific treatment methods for diphtheria.

What are the key symptoms of diphtheria?

Symptoms of diphtheria typically appear 2-5 days after exposure and can range from mild to severe. Let us discuss in detail the key symptoms of diphtheria and its effects on the physiological system:

• Sore Throat: The bacterium Corynebacterium diphtheriae releases a toxin that damages the mucous membranes in your nose and throat. This toxin leads to an accumulation of dead healthy tissues in the throat region, which eventually forms a thick membrane.
• Fever: Diphtherial toxin triggers an immune response in the body, resulting in a high fever. The pathogen produces a toxin that damages tissues in your respiratory tract, which eventually activates the immune system to fight off the infection, leading to a fever. It is a common diphtheria symptom associated with chills and tiredness.
• Swollen Neck Glands: Corynebacterium diphtheriae damages the tissues of your neck and throat region. In these damaged tissues, your immune system sends various immune cells to the affected region, causing the accumulation of white blood cells. This influx of immune cells and fluids causes inflammation and swelling in the neck lymph nodes.
• Difficulty in Breathing or Swallowing: Diphtherial toxin forms a thick grey-coloured coating (pseudomembrane) in your throat and nose region. It is the hallmark of diphtheria, especially in children and adults, which obstructs the airways, making it difficult to breathe and swallow. Additionally, the toxin can damage the nerve involved in breathing or swallowing.
• Hoarseness: The pseudomembrane in the larynx and throat can affect the vocal cords and surrounding tissues. This bacterial toxin can sometimes damage the healthy tissues of your larynx and pharynx, causing changes in voice, resulting in hoarseness. Besides hoarseness, diphtheria can lead to heart problems due to damage to the cardiac muscles by the toxin.
• Nasal Discharge: It is quite common, particularly in nasal diphtheria, where the bacterium Corynebacterium diphtheriae infects the nasal passage. This can also form a pseudomembrane in the nasal passages, causing inflammation and irritation. Frequent irritation in the delicate linings of the nasal membrane can result in nasal discharge and post-nasal drip.
• Croup-like Cough: Diphtherial toxin mainly invades your respiratory system, causing damage to the tissues of the lungs, throat and nose. Accumulation of these healthy tissues causes inflammation and irritation in the bronchioles, causing obstruction in breathing and a characteristic barking similar to croup. Moreover, patients produce a high-pitched whistling sound, which is known as 'stridor'.
• Bluish Skin: Cyanosis, or bluish skin, is one of the common diphtheria symptoms, due to a limited supply of oxygen in the blood. A blocked airway due to pseudomembrane leads to a buildup of carbon dioxide and a decrease in oxygen levels in the blood. This lack of oxygen manifests as bluish discolouration of the skin.
• Skin Sores: It is one of the most common diphtheria symptoms that affects cutaneous tissues. Apart from affecting your respiratory system, it can also affect and multiply in skin lesions, damaging your cutaneous tissues. Additionally, accumulation of the bacterial toxin under your skin can lead to ulcers.
   

What are the diagnostic tests for diphtheria?

Doctors diagnose diphtheria through a combination of clinical assessment, swab tests, and laboratory analysis. Here, we will discuss some common diagnostic tests to detect Corynebacterium diphtheriae in a patient’s sample. These include:

• Swab Test: A swab test is a common test that diagnoses diphtheria, where a healthcare professional collects a swab from the throat or nose. After that, they send the sample to any lab to culture and identify the diphtherial bacterium. 
• Bacterial Culture: Doctors collect bacterial samples from the throat of an infected individual and culture them in a laboratory in petri dishes to grow the bacterial colony. Pathologists grow these bacteria in those specific cultures at 37℃ for 24-48 hours with selective media.  
• PCR (Polymerase Chain Reaction): PCR (polymerase chain reaction) is a molecular method that helps in detecting the presence of the diphtheria toxin gene in the bacteria Corynebacterium diphtheriae. It is a rapid and sensitive technique that can help confirm a diagnosis of diphtheria, especially in cases where conventional methods may be slower or less accurate.
• Serological Tests: Serological tests for diphtheria primarily detect antibodies against the bacterial toxin in a patient’s blood. These tests, often using methods like ELISA, help determine if that person has been previously infected or vaccinated against diphtheria and whether they have protective levels of antibodies.  
• Elek Test: Sometimes, doctors can suggest this laboratory method to determine if a strain of Corynebacterium is toxigenic or not. It is a type of immunoprecipitation test that detects the presence of toxin through a visible precipitate when the bacterial toxin interacts with the diphtheria antitoxin.  
• Schick Test: It is a rapid diagnostic test to determine if anyone is suffering from diphtheria. Doctors use Schick’s test to check the antibodies in a patient’s blood sample against a particular strain of diphtheria bacterium. Due to its false positive reaction (hypersensitivity to the toxin), doctors do not recommend it in acute or chronic cases of diphtheria.
   

What are the treatments for diphtheria?

Healthcare providers treat diphtheria signs and symptoms with a combination of diphtheria antitoxin and antibiotics. Early treatment is crucial to prevent severe complications. Additionally, people with diphtheria may also need supportive care, like respiratory support or airway maintenance.

Let us explore some of the common treatments for diphtheria:

• Diphtheria Antitoxin

In certain cases, doctors administer this to neutralise the diphtheria toxin circulating in your body. It is usually given intravenously or intramuscularly.

• Antibiotics

Antibiotics like penicillin or erythromycin help kill the Corynebacterium diphtheriae bacteria, reducing the infection and its contagiousness. Doctors specifically prescribe these for 10–14 days, depending on clinical judgment.

• Supportive Care

This may include:
 

1. Respiratory support: If anyone is facing breathing difficulties, a breathing tube (endotracheal intubation) or tracheostomy might be necessary.
2. Airway management: Doctors may need to clear any obstruction in your airway due to the presence of a pseudomembrane.
3. Monitoring: Close monitoring of heart and neurological function is important due to potential complications like myocarditis and neuritis.
4. Vaccination: Doctors give the DTaP vaccine in a series of five doses, which include 2 months, 4 months, 6 months, 15-18 months, and 4-6 years.
    

Final Words

People suffering from diphtheria symptoms often require hospitalisation, sometimes in an intensive care unit. This is due to the severity of the illness and the requirement for close monitoring and potential interventions. Prompt treatment with antitoxin and antibiotics significantly improves the chances of recovery and reduces the risk of complications. Additionally, getting vaccinated at the proper age can make you immune to the disease.