How to treat diphtheria at home

Diphtheria is a disease caused by several species of corynebacteria of the diphtheriae complex. There is an effective, mandatory vaccine for children and health professionals. Doctissimo takes stock of this disease.

Summary
What is diphtheria?
The causes of diphtheria
Diphtheria: transmission and incubation time
The symptoms of diphtheria
Diphtheria: the complications of the disease
Diphtheria: treatments
Vaccination against diphtheria

What is diphtheria?
Diphtheria is a disease caused by several species of corynebacteria of the diphtheriae complex.

There are several types of diphtheria:

Respiratory diphtheria which induces paralysis of the central nervous system, or diaphragm and throat, resulting in death by asphyxiation;
Cutaneous diphtheria.
There is an effective, mandatory vaccine for children and health professionals. Diphtheria has become a very rare disease thanks to vaccination. The mortality was of the order of 50%.

The causes of diphtheria
The diphtheria bacillus (Klebs-Loëffler bacillus) determines on the tonsils the formation of a “false membrane” and secretes a neurotropic toxin responsible for paralysis.

Diphtheria: transmission and incubation time
C. diphtheriae is transmitted directly through nasopharyngeal secretions or cutaneous wounds. There are very rare cases of transmission by indirect contact (objects soiled by patient secretions). C.ulcerans is transmitted through milk and cattle contacts (some professions are therefore more at risk: farmers, veterinarians). Contacts with cats or dogs have been described. More rarely, C. pseudotuberculosis can also be transmitted to humans by goats.

The incubation period for diphtheria is usually 2 to 5 days.

The symptoms of diphtheria
The signs of beginnings are commonplace: a coryza, a slight fever, a vaguely red throat. A few hours later appears angina with false membranes. An amygdala is seen as a white coating with sharp boundaries that protrude upwards and tapers along the free edge of the soft palate. The child is pale, tired, the fever remains between 38 ° and 39 ° C, bilateral cervical ganglia are palpated.

Spontaneously, the false membrane gradually extends to the uvula and the bottom of the pharynx. The extension to the larynx causes the “croup”. The toxin causes paralysis of swallowing (paralysis bike-palate), ocular paralysis, diaphragm and limbs.

Under the influence of the treatment, the evolution is quickly stopped, the false membranes are peeled off and the throat returns to a normal aspect in 48 hours.

Malignant diphtheria angina is a peculiar form that begins abruptly with a high fever and an alteration of the general state with pallor and prostration. The foul smell of angina is perceived from a distance. the neck is deformed by bilateral ganglia, voluminous, painful (“proconsular neck”). Edema of the bulky throat is noted. The false membranes are large and haemorrhagic. A bloody coryza is associated with angina. The toxic signs are in the foreground: major asthenia, pulse small, fast, running, muffled heart sounds, drop in blood pressure, profuse haemorrhages, oliguria, albuminuria, elevated blood urea. Evolution is fatal most often despite treatments.

Croup is the laryngeal location that follows angina. The child has dysphonia and a barking cough. The association: “hoarse cough + dead voice” must evoke diphtheria.

Diphtheria: the complications of the disease
The course of the disease depends on the general condition of the patient and the timing of appropriate treatment. Treatment is urgent to prevent spontaneous progression to laryngeal dyspnea and asphyxia.

Complications can be:

Inflammation of the heart muscle or myocarditis (requires regular monitoring of the electrocardiogram);
Neurological Disorders: primarily various paralyzes manifesting as swallowing disorders and respiratory depression;
Inflammation of the liver;
Alteration of renal function.
Diphtheria: treatments
Treatment of diphtheria is based on anti-diphtheria serum intramuscular injection.

Penicillin and erythromycin are useful against secondary infections. Antibiotic therapy with amoxicillin or macrolides is recommended for allergy to beta-lactams.

It is necessary to detect healthy carriers in the surrounding area (throat swabbing, Schick’s intradermic reaction).

In case of croup, the child must be sent to a resuscitation center: intubation or tracheotomy may be necessary.

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