Diphtheria

Last reviewed: 25 Aug 2022
Last updated: 13 Apr 2022

Summary

Definition

History and exam

Key diagnostic factors

  • typical age group (<15 years or >25 years)
  • exposure to infected individual
  • travel to endemic regions
  • unvaccinated/inadequately vaccinated individuals
  • sore throat
  • dysphagia or dysphonia
  • dyspnea
  • croupy cough
  • pseudomembrane formation
  • swelling of the neck
  • skin lesions
  • respiratory compromise
More key diagnostic factors

Other diagnostic factors

  • low-grade fever
  • stridor
Other diagnostic factors

Risk factors

  • unvaccinated individuals
  • inadequately vaccinated individuals
  • exposure to an infected individual
  • travel to endemic areas
  • skin breakdown
  • poor hygiene, overcrowding, and poverty
More risk factors

Diagnostic investigations

1st investigations to order

  • bacteriologic culture and microscopy
More 1st investigations to order

Investigations to consider

  • Elek test for toxigenicity
  • diphtheria antibodies
  • PCR
More investigations to consider

Treatment algorithm

INITIAL

close contacts of respiratory and cutaneous cases

ACUTE

respiratory diphtheria

cutaneous diphtheria

asymptomatic carriers

Contributors

Authors

Walid Abuhammour, MD, FAAP, FIDSA

Professor of Paediatrics

Al Jalila Children's Specialty Hospital

Dubai

UAE

Disclosures

WA declares that he has no competing interests.

Sarmad Farook Yahya Alhamdani, MBCHB, CABP, FICMS

Consultant Paediatrician

Al Jalila Children's Specialty Hospital

Dubai

UAE

Disclosures

SFYA declares that he has no competing interests.

Nida Yousef, MD

Pediatric Cardiology Fellow

Advocate Hope Children's Hospital

Chicago

IL

Disclosures

NY declares that she has no competing interests.

Peer reviewers

William A. Petri, Jr, MD, PhD, FACP

Chief and Professor of Medicine

Division of Infectious Diseases and International Health

University of Virginia Health System

Charlottesville

VA

Disclosures

WAP declares that he has no competing interests.

George Y. Wu, MD, PhD

Professor of Medicine

University of Connecticut Health Center

Farmington

CT

Disclosures

GYW is on the medical advisory boards of the following: Gilead Sciences, Bristol-Myers Squibb, AbbVie, and Intercept.

Linda S. Nield, MD

Associate Professor of Pediatrics

West Virginia University School Of Medicine

Morgantown

WV

Disclosures

LSN declares that she has no competing interests.

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