DIPTHERIA

 DEFINITION
Diptheria is an acute bacterial
disease that can infect the body in
two areas the throat (respiratory
diptheria) and the skin (cutaneous
diptheria)
ETIOLOGIC AGENT:
Corynebacterium diptheriae
(Klebs-Leoffler-Bacillus)
It has 3 strains of organisms:
a.Gravis(severe) is the strain that produces
the most severe and greatest number of fatal
cases in Europe.
b. Mitis(mild) is the strain that produces
lesions extending to the larynx and lungs but
is rarely a cause of death.
c. Intermedius (intermediate) is related to
gravis but result in a tendency to bleed.
INCUBATION PERIOD
It usually takes two to five days for sx to develop.
 PERIOD OF COMMUNICABILITY
The period of communicability varies. It is more than
two to four weeks in untreated pts. and one to two days
in treated pts.
 SOURCE OF INFECTION
Infection can come from discharges of the nose,
pharynx and eyes or lesions on other parts of the body of
infected persons.
 MODE OF TRANSMISSION
Is transmitted through contact with a pt. or a carrier,
or with articles soiled with discharges of infected persons.
PREDISPOSING FACTORS
An operation in an area of the nose and
throat
Economic status
Lack of proper nutrition
Overcrowding
TYPES OF DIPTHERIA
• Nasal
• Tonsilar- has a low fatality rate.
• Facial Nasopharyngeal (more severe)
-apperance of “bull's neck”
• Laryngeal (most severe)
-commonly found in children.
• Wound or cutaneous diptheria
DIAGNOSTIC TESTS
 Swab from nose and throat or other suspected
lesions
 Virulence test
 Schick test
 Molony test
 Loeffler test
CLINICAL MANIFESTATIONS
 Fatigue, malaise, slight sore throat, and elevated
temperature
 Inflammatory reaction is iniated by the body.
 Cervical Adenitis
 Body malaise, weakness, apathy and rapid PR
 “Bull's neck” (swelling of the neck)
 Husky Voice
 Swelling of the palate
 Yellow spots (similar to impetigo)
TREATMENT MODALITIES
 DRUGS:
 Penicillin is usually effective in treating respiratory
diptheria before it releases toxins in the blood.
 Antitoxin can be given in combination with Penicillin.
(skin test is necessary)
 Erythromycin , 40mg/kg bw in 4 doses for x 7 to 10
days.
 SUPPORTIVE THERAPY:
 maintenance of adequate nutrition
 adequate fluid and electrolyte balance
 bed rest
 oxygen inhalation
NURSING MANAGEMENT
• CBR with BRP for at least two weeks. To
conserve energy and decrease cardiac
workload.
• Soft diet is recommemded. Small frequent
feedings are advised.
• Drink fruit juice with Vitamin C to maintain the
alkalinity of the blood and increase his/ her
resistance.
• Ice collar must be applied to the neck.
• Nose and throat must be taken care of
 NURSING DIAGNOSIS
 Inffective airway clearance
 Risk for activity intolerance
 Poor tissue perfusion
 Fear
 Anxiety
 COMPLICATIONS
• Myocarditis
• Polyneuritis
• Airway Obstruction may lead to death through
asphyxiation
• Cervical Adenitis
• Otitis Media
• Bronchopneumonia
PREVENTION
1. Cases of diptheria must be mandatorily reported.
2. Patients should be isolated for a minimum of fourteen
days from the onset pf the disease until three cultures
from the nose and throat are reported negative.
3. Patient should avoid contact with children and refrain
from handling food until bacteriologic examination of
cultures is reported negative.
4. Children under five years old should be given booster
doses of diptheria tetanus vaccine
5. DPT immunization of babies is mandatory.