Diphtheria refers to life-threatening acute infectious diseases, causes inflammation of the upper respiratory tract or cuts of the skin, abrasions. But the danger of diphtheria is not a local lesion, but a general intoxication and toxic damage to the cardiovascular and nervous systems.
Before diphtheria serums and inoculations were widely introduced into medical practice, the incidence of diphtheria was very high, 50% of cases occurred in severe toxic forms. After the spread of serum, the likelihood of developing diphtheria is significantly reduced, severe forms of the disease are almost not found.
The causative agent of diphtheria is Gram-positive bacteria. They are like wands, bulbous, thickened at the ends. Bacteria are arranged in pairs, at an angle and form a Roman numeral of five( V).In the process of life, bacteria secrete diphtheria toxin. The severity of the disease and the danger to life depend on the amount of toxin produced.
The main routes of infection:
- airborne( from patients with diphtheria or from healthy carriers of bacteria);
- through infected items.
Blood flow carries the toxin throughout the body, affecting the heart muscle, kidneys and nervous system. Depending on the affected area diphtheria happens:
- respiratory tract;
- of the nose;
- of rare localizations( skin, wound surfaces, genital organs).
Initially, the symptoms of diphtheria differ depending on the affected area:
- diphtheria of causes: fever, soreness in swallowing, redness and swelling of the tonsils( specific filmy coating), anterior anterior cervical lymph nodes;
- diphtheria of the nose - a slight increase in temperature, serous purulent or bloody purulent discharge from the nasal passages, the appearance of wet sections on the wings of the nose, cheeks, forehead and chin( after dry crusts), as well as filmy raids inside the nose;
- diphtheria - mild hyperemia and edema of the conjunctiva of the eyelid, a small amount of serous-purulent discharge from the conjunctival sac;
- skin diphtheria - prolonged non-healing of any skin lesions, hyperemia, the appearance of a dirty-gray coating on the skin, dense infiltration of the surrounding skin.
Then diphtheria flows into a toxic form, which proceeds very hard. There is a high fever( 39-41 ° C), severe headaches, drowsiness, apathy.
Symptoms of the initial, mild stage of diphtheria can be confused with other diseases( angina, conjunctivitis).Distinctive symptoms are the appearance of characteristic films.
If a diphtheria is suspected, the doctor will prescribe such tests:
- a general blood test;
- smear under a microscope( bacterioscopy);
- bacteriological study;
- determination of the level( titer) of antitoxic antibodies;
- serological examination.
When confirming diphtheria infection, the first step of treatment is mandatory admission to the infectious disease department.
Further treatment is carried out using:
- etiotropic therapy;
- local treatment;
- detoxification therapy;
- glucocorticosteroids( in particularly severe cases).
Diet is that the patient is recommended to use only vitaminized, high-calorie, thoroughly processed food.
Etiotropic therapy is aimed at eliminating the cause of the disease. It is carried out due to the introduction of antidiphtheria serum( PDS).
Antibiotics are prescribed depending on the form of the disease. If the disease is mild, Erythromycin or Rifampicin may help. For moderate and severe forms, the doctor will prescribe penicillins or cephalosporins internally injectively. Antibiotics can not destroy the diphtheria toxin, but will reduce the number of bacteria that produce it.
Local treatment with will help to locally relieve the symptoms.
Detoxication therapy is performed with the help of glucose-salt solutions for moderate and severe forms of the disease in order to maintain the required daily amount of fluid taking into account its losses.
Diphtheria is dangerous because of severe complications that it can cause. The most serious among them are myocarditis and cardiac arrhythmia.
Diphtheria also causes:
- neurological complications of - paralysis of accommodation, strabismus, paresis of limbs, paralysis of the respiratory muscles and the muscles of the diaphragm;
- secondary complications - acute cerebrovascular accident( thrombosis, embolism), metabolic encephalopathy, cerebral edema, toxic kidney damage, hepatitis, infectious-toxic shock and DIC-syndrome, acute renal, cardiovascular, respiratory or multiple organ failure;
- nonspecific complications - paratonsillar abscess, otitis media, pneumonia.
Methods for the prevention of diphtheria
Due to the development of very effective methods for the prevention of diphtheria, the number of cases of infection and the onset of deaths is significantly reduced. As a method of active immunization vaccinations are used:
- ADKS-m( for weakened children).
Children can be vaccinated quite heavily. The body temperature can rise, there may be swelling at the injection site, a general malaise can be observed.
The first vaccination of children is carried out at the age of three months, repeated three times at intervals of one and a half months( at 4-5, then 6-7 months), followed by revaccination at the age of one and a half to two years.
Diphtheria is a very dangerous disease that can lead to serious complications and an unfavorable outcome. The vaccination is carried out on time, although it is hard for the children to bear, but it helps to reduce the probability of infection and avoid possible consequences.