Diphtheria

 

Complications of Diphtheria

Diphtheria, caused by the exotoxin produced by Corynebacterium diphtheriae, is a toxin-mediated disease. Most complications arise from the local effects of the pseudomembrane or the systemic distribution of the exotoxin.


1. Systemic and Local Complications

System Complication
Cardiac Myocarditis: The most common cause of death. Presents with arrhythmias and heart failure.
Neurological Polyneuritis: Palatal paralysis (early) and peripheral neuritis (late).
Respiratory Airway Obstruction: Due to the spread of the thick, gray pseudomembrane into the larynx/trachea.

2. High-Yield Clinical Pearls

  • Bull Neck: Massive cervical lymphadenopathy combined with soft tissue edema, giving the neck a “bull-like” appearance; indicates severe toxin load.
  • Early vs. Late Neuropathy: Palatal paralysis (nasal speech, regurgitation of fluids through the nose) typically occurs early, whereas ocular palsies or peripheral nerve involvement occur later.
  • Treatment: The priority is Diphtheria Antitoxin (DAT) to neutralize circulating toxin; antibiotics (Erythromycin or Penicillin) are secondary to halt toxin production.

NEET PG Hint: Remember: Myocarditis in diphtheria can occur even after the local throat infection has subsided; thus, continuous ECG monitoring is mandatory for all confirmed cases. For more high-yield infectious disease protocols and free medical questions, visit mymedschool.org.