Diphtheria classification: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Diphtheria}} | {{Diphtheria}} | ||
{{CMG}}; {{AE}}{{DN}} | {{CMG}}; {{AE}} {{DN}} | ||
==Overview== | ==Overview== | ||
[[Diphtheria]] can be classified according to the type of [[Corynebacterium]] that causes a specific case. It can also be divided according to the resulting clinical presentation into [[respiratory]], [[systemic]], or [[cutaneous]] [[diphtheria]]. | |||
==Classification== | ==Classification== | ||
[[Diphtheria]] infection | [[Diphtheria]] infection can be classified according to either the causative agent or the clinical manifestations of the infection. | ||
===Causative Agent=== | ===Causative Agent=== | ||
[[Diphtheria]] can be caused by several '''''[[Corynebacterium]]''''' species | [[Diphtheria]] can be caused by several '''''[[Corynebacterium]]''''' species including:<ref name="pmid6321350">{{cite journal |vauthors=Wong TP, Groman N |title=Production of diphtheria toxin by selected isolates of Corynebacterium ulcerans and Corynebacterium pseudotuberculosis |journal=Infect. Immun. |volume=43 |issue=3 |pages=1114–6 |year=1984 |pmid=6321350 |pmc=264307 |doi= |url=}}</ref><ref name="pmid26189434">{{cite journal |vauthors=Moore LS, Leslie A, Meltzer M, Sandison A, Efstratiou A, Sriskandan S |title=Corynebacterium ulcerans cutaneous diphtheria |journal=Lancet Infect Dis |volume=15 |issue=9 |pages=1100–7 |year=2015 |pmid=26189434 |doi=10.1016/S1473-3099(15)00225-X |url=}}</ref> | ||
*'''''[[Corynebacterium]] [[diphtheria]]''''' | *'''''[[Corynebacterium]] [[diphtheria]]''''', which can be further divided into 4 types based on morphologic and biochemical properties:<ref name="pmid10657205">{{cite journal |vauthors=Efstratiou A, Engler KH, Mazurova IK, Glushkevich T, Vuopio-Varkila J, Popovic T |title=Current approaches to the laboratory diagnosis of diphtheria |journal=J. Infect. Dis. |volume=181 Suppl 1 |issue= |pages=S138–45 |year=2000 |pmid=10657205 |doi=10.1086/315552 |url=}}</ref> | ||
**''Var. gravis'' | |||
**''Var. mitis'' | |||
**''Var. belfanti'' | |||
**''Var. intermedius'' | |||
*'''''[[Corynebacterium]] ulcerans''''' | *'''''[[Corynebacterium]] ulcerans''''' | ||
*'''''[[Corynebacterium]] hemolyticum''''' | *'''''[[Corynebacterium]] hemolyticum''''' | ||
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===Clinical Manifestations=== | ===Clinical Manifestations=== | ||
[[Diphtheria]] infection can present in | [[Diphtheria]] infection can present in any of the following ways:<ref name= "CDC"> Center for Disease Control and Prevention http://www.cdc.gov/diphtheria/clinicians.html Accessed on Oct. 7, 2016. </ref> | ||
*[[Respiratory]] [[diphtheria]], which | *[[Respiratory]] [[diphtheria]], which can be further divided into [[nasal]], [[pharyngeal]], and [[laryngeal]] [[diphtheria]]<ref name="pmid490806">{{cite journal |vauthors=Dobie RA, Tobey DN |title=Clinical features of diphtheria in the respiratory tract |journal=JAMA |volume=242 |issue=20 |pages=2197–201 |year=1979 |pmid=490806 |doi= |url=}}</ref> | ||
*Systemic [[diphtheria]], which results from the dissemination of [[diphtheria]] toxin into the heart<ref name="pmid14715320">{{cite journal |vauthors=Lumio JT, Groundstroem KW, Melnick OB, Huhtala H, Rakhmanova AG |title=Electrocardiographic abnormalities in patients with diphtheria: a prospective study |journal=Am. J. Med. |volume=116 |issue=2 |pages=78–83 |year=2004 |pmid=14715320 |doi= |url=}}</ref><ref name="pmid18103551">{{cite journal |vauthors=BOYER NH, WEINSTEIN L |title=Diphtheritic myocarditis |journal=N. Engl. J. Med. |volume=239 |issue=24 |pages=913–9 |year=1948 |pmid=18103551 |doi=10.1056/NEJM194812092392403 |url=}}</ref>, kidneys and nervous system<ref name="pmid490806">{{cite journal |vauthors=Dobie RA, Tobey DN |title=Clinical features of diphtheria in the respiratory tract |journal=JAMA |volume=242 |issue=20 |pages=2197–201 |year=1979 |pmid=490806 |doi= |url=}}</ref> | *[[Systemic]] [[diphtheria]], which results from the dissemination of [[diphtheria]] toxin into the [[heart]]<ref name="pmid14715320">{{cite journal |vauthors=Lumio JT, Groundstroem KW, Melnick OB, Huhtala H, Rakhmanova AG |title=Electrocardiographic abnormalities in patients with diphtheria: a prospective study |journal=Am. J. Med. |volume=116 |issue=2 |pages=78–83 |year=2004 |pmid=14715320 |doi= |url=}}</ref><ref name="pmid18103551">{{cite journal |vauthors=BOYER NH, WEINSTEIN L |title=Diphtheritic myocarditis |journal=N. Engl. J. Med. |volume=239 |issue=24 |pages=913–9 |year=1948 |pmid=18103551 |doi=10.1056/NEJM194812092392403 |url=}}</ref>, kidneys and nervous system<ref name="pmid490806">{{cite journal |vauthors=Dobie RA, Tobey DN |title=Clinical features of diphtheria in the respiratory tract |journal=JAMA |volume=242 |issue=20 |pages=2197–201 |year=1979 |pmid=490806 |doi= |url=}}</ref> | ||
*[[Cutaneous]] [[diphtheria]], which is caused by toxigenic and non-toxigenic strains of '''''[[Corynebacterium]] [[diphtheria]]<ref name="pmid27373251">{{cite journal |vauthors=Rappold LC, Vogelgsang L, Klein S, Bode K, Enk AH, Haenssle HA |title=Primary cutaneous diphtheria: management, diagnostic workup, and treatment as exemplified by a rare case report |journal=J Dtsch Dermatol Ges |volume=14 |issue=7 |pages=734–6 |year=2016 |pmid=27373251 |doi=10.1111/ddg.12722 |url=}}</ref> | *[[Cutaneous]] [[diphtheria]], which is caused by toxigenic and non-toxigenic strains of '''''[[Corynebacterium]] [[diphtheria]]<ref name="pmid27373251">{{cite journal |vauthors=Rappold LC, Vogelgsang L, Klein S, Bode K, Enk AH, Haenssle HA |title=Primary cutaneous diphtheria: management, diagnostic workup, and treatment as exemplified by a rare case report |journal=J Dtsch Dermatol Ges |volume=14 |issue=7 |pages=734–6 |year=2016 |pmid=27373251 |doi=10.1111/ddg.12722 |url=}}</ref> | ||
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{{WH}}{{WS}} | {{WH}}{{WS}} | ||
[[Category:Emergency medicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
[[Category:Pulmonology]] | |||
[[Category:Pediatrics]] | |||
[[Category:Dermatology]] | |||
Latest revision as of 21:23, 29 July 2020
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Diphtheria classification On the Web |
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American Roentgen Ray Society Images of Diphtheria classification |
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Risk calculators and risk factors for Diphtheria classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]
Overview
Diphtheria can be classified according to the type of Corynebacterium that causes a specific case. It can also be divided according to the resulting clinical presentation into respiratory, systemic, or cutaneous diphtheria.
Classification
Diphtheria infection can be classified according to either the causative agent or the clinical manifestations of the infection.
Causative Agent
Diphtheria can be caused by several Corynebacterium species including:[1][2]
- Corynebacterium diphtheria, which can be further divided into 4 types based on morphologic and biochemical properties:[3]
- Var. gravis
- Var. mitis
- Var. belfanti
- Var. intermedius
- Corynebacterium ulcerans
- Corynebacterium hemolyticum
- Corynebacterium pseudotuberculosis
Clinical Manifestations
Diphtheria infection can present in any of the following ways:[4]
- Respiratory diphtheria, which can be further divided into nasal, pharyngeal, and laryngeal diphtheria[5]
- Systemic diphtheria, which results from the dissemination of diphtheria toxin into the heart[6][7], kidneys and nervous system[5]
- Cutaneous diphtheria, which is caused by toxigenic and non-toxigenic strains of Corynebacterium diphtheria[8]
References
- ↑ Wong TP, Groman N (1984). "Production of diphtheria toxin by selected isolates of Corynebacterium ulcerans and Corynebacterium pseudotuberculosis". Infect. Immun. 43 (3): 1114–6. PMC 264307. PMID 6321350.
- ↑ Moore LS, Leslie A, Meltzer M, Sandison A, Efstratiou A, Sriskandan S (2015). "Corynebacterium ulcerans cutaneous diphtheria". Lancet Infect Dis. 15 (9): 1100–7. doi:10.1016/S1473-3099(15)00225-X. PMID 26189434.
- ↑ Efstratiou A, Engler KH, Mazurova IK, Glushkevich T, Vuopio-Varkila J, Popovic T (2000). "Current approaches to the laboratory diagnosis of diphtheria". J. Infect. Dis. 181 Suppl 1: S138–45. doi:10.1086/315552. PMID 10657205.
- ↑ Center for Disease Control and Prevention http://www.cdc.gov/diphtheria/clinicians.html Accessed on Oct. 7, 2016.
- ↑ 5.0 5.1 Dobie RA, Tobey DN (1979). "Clinical features of diphtheria in the respiratory tract". JAMA. 242 (20): 2197–201. PMID 490806.
- ↑ Lumio JT, Groundstroem KW, Melnick OB, Huhtala H, Rakhmanova AG (2004). "Electrocardiographic abnormalities in patients with diphtheria: a prospective study". Am. J. Med. 116 (2): 78–83. PMID 14715320.
- ↑ BOYER NH, WEINSTEIN L (1948). "Diphtheritic myocarditis". N. Engl. J. Med. 239 (24): 913–9. doi:10.1056/NEJM194812092392403. PMID 18103551.
- ↑ Rappold LC, Vogelgsang L, Klein S, Bode K, Enk AH, Haenssle HA (2016). "Primary cutaneous diphtheria: management, diagnostic workup, and treatment as exemplified by a rare case report". J Dtsch Dermatol Ges. 14 (7): 734–6. doi:10.1111/ddg.12722. PMID 27373251.