Page 170 - ירושלים: גיליון רפואי

Medical File No. 003

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Name of disease: Diphtheria

Cause and Diphtheria is caused by the Corynebacterium diphtheriae bacterium. It was first
transmission described in the 5th century BCE by Hippocrates.
Infection with this bacterium can present as a severe inflammation of the respiratory
system, skin inflammation or septicemia.
This very infectious disease is transmitted from one person to another by means of
respiratory secretions – coughing or sneezing. Domestic pets such as cats can act
as incubators for the bacteria. The disease is mainly active in winter and spring, and
usually attacks children under 5 years of age and adults over 40 years old. Diphtheria
is common mainly among populations living in overcrowded and poor hygienic
conditions that suppress immunity.

Symptoms Signs of the disease develop two to five days after infection. The first symptom is
and a sore throat, followed by severe inflammation of the mouth and upper respiratory
progression tract and development of a whitish-gray film called a pseudomembrane. The lymph
glands in the neck subsequently become swollen, giving it a bull-like appearance.
The membranes can develop to the point where they block the respiratory airway,
a process that may lead to suffocation and death. Cutaneous diphtheria appears as
skin ulcers that do not heal that are also covered with a characteristic membrane.
Cutaneous diphtheria can lead to the respiratory form of the disease. Diphtheria
bacteria may create a toxin that leads to the destruction of mucous membranes and
skin cells and may severely damage the heart, kidneys and brain. Left untreated,
diphtheria results in death in approximately 20% of cases, particularly among
children and the elderly.

Treatment Treatment includes isolation of the patient, removing the pseudomembranes
and to ensure an open airway and, in very severe cases, intubation. Antibiotics
medications (erythromycin or penicillin) are given intravenously and an antitoxin administered.

Notes Before vaccination against the disease was developed, diphtheria caused severe
epidemics with high mortality. In 1892 a diphtheria epidemic broke out in Jerusalem;
the three children of Eliezer Ben-Yehuda, the reviver of the Hebrew language, were
among the victims. However, vaccination has now rendered the disease rare in
developed countries.

Name of Prof. Haim Springer Signature
physician

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