Diphtheria natural history, complications and prognosis: Difference between revisions
| Line 7: | Line 7: | ||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
===Natural | ===Natural History=== | ||
The symptoms of diphtheria usually develops after incubation period of 2-4 days, and start with symptoms such as sorethroat, high grade fever, myalgias, lymphadenopathy, hoarseness, dyspnea, rhinorrhea and difficulty swallowing. Without treatment, it may progress to cause airway obstruction, neuropathies, myocarditis, septicemia, shock and death.<ref name="pmid490806">{{cite journal| author=Dobie RA, Tobey DN| title=Clinical features of diphtheria in the respiratory tract. | journal=JAMA | year= 1979 | volume= 242 | issue= 20 | pages= 2197-201 | pmid=490806 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=490806 }} </ref><ref name="pmid14069096">{{cite journal| author=MORGAN BC| title=CARDIAC COMPLICATIONS OF DIPHTHERIA. | journal=Pediatrics | year= 1963 | volume= 32 | issue= | pages= 549-57 | pmid=14069096 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14069096 }} </ref> | The symptoms of diphtheria usually develops after incubation period of 2-4 days, and start with symptoms such as sorethroat, high grade fever, myalgias, lymphadenopathy, hoarseness, dyspnea, rhinorrhea and difficulty swallowing. Without treatment, it may progress to cause airway obstruction, neuropathies, myocarditis, septicemia, shock and death.<ref name="pmid490806">{{cite journal| author=Dobie RA, Tobey DN| title=Clinical features of diphtheria in the respiratory tract. | journal=JAMA | year= 1979 | volume= 242 | issue= 20 | pages= 2197-201 | pmid=490806 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=490806 }} </ref><ref name="pmid14069096">{{cite journal| author=MORGAN BC| title=CARDIAC COMPLICATIONS OF DIPHTHERIA. | journal=Pediatrics | year= 1963 | volume= 32 | issue= | pages= 549-57 | pmid=14069096 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14069096 }} </ref> | ||
Revision as of 16:52, 9 February 2017
|
Diphtheria Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Diphtheria natural history, complications and prognosis On the Web |
|
American Roentgen Ray Society Images of Diphtheria natural history, complications and prognosis |
|
FDA on Diphtheria natural history, complications and prognosis |
|
CDC on Diphtheria natural history, complications and prognosis |
|
Diphtheria natural history, complications and prognosis in the news |
|
Blogs on Diphtheria natural history, complications and prognosis |
|
Risk calculators and risk factors for Diphtheria natural history, complications and prognosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2], Aysha Anwar, M.B.B.S[3]
Overview
Diphtheria is a vaccine-preventable disease that can lead to such severe complications as respiratory failure, myocarditis, polyneuropathies, and death.[1][2][3][4][5][6] The overall case-fatality rate for diphtheria is 5%–10%, with higher death rates (up to 20%) among patients younger than 5 and older than 40 years of age.[7]
Natural History, Complications, and Prognosis
Natural History
The symptoms of diphtheria usually develops after incubation period of 2-4 days, and start with symptoms such as sorethroat, high grade fever, myalgias, lymphadenopathy, hoarseness, dyspnea, rhinorrhea and difficulty swallowing. Without treatment, it may progress to cause airway obstruction, neuropathies, myocarditis, septicemia, shock and death.[1][2]
Complications
Complications that can develop as a result of diphtheria are:[2][8][9][10][3][4][5][6]
- Respiratory failure
- Myocarditis
- Heart failure
- Polyneuropathies
- 10th cranial nerve disorder
- 9th cranial nerve disorder
- Peripheral motor neuropathy
- Diaphragm paralysis
- Neurogenic bladder dysfunction
- Acute renal failure
- Septicemia
- Death
Prognosis
The overall case-fatality rate for diphtheria is 5%–10%, with higher death rates (up to 20%) among persons younger than 5 and older than 40 years of age.[7] Prognosis of diphtheria varies based on following factors:[11][12][13][6]
Good prognostic factors
- Early diagnosis and treatment
- Age>15 years
- Absence of cardiac involvement
Poor prognostic factors
- Delayed diagnosis and treatment
- Age<15 years
- Presence of cardiac involvement
- Presence of complications
- Immunocompromised status
References
- ↑ 1.0 1.1 Dobie RA, Tobey DN (1979). "Clinical features of diphtheria in the respiratory tract". JAMA. 242 (20): 2197–201. PMID 490806.
- ↑ 2.0 2.1 2.2 MORGAN BC (1963). "CARDIAC COMPLICATIONS OF DIPHTHERIA". Pediatrics. 32: 549–57. PMID 14069096.
- ↑ 3.0 3.1 Sanghi V (2014). "Neurologic manifestations of diphtheria and pertussis". Handb Clin Neurol. 121: 1355–9. doi:10.1016/B978-0-7020-4088-7.00092-4. PMID 24365424.
- ↑ 4.0 4.1 Jain A, Samdani S, Meena V, Sharma MP (2016). "Diphtheria: It is still prevalent!!!". Int J Pediatr Otorhinolaryngol. 86: 68–71. doi:10.1016/j.ijporl.2016.04.024. PMID 27260583.
- ↑ 5.0 5.1 http://www.who.int/immunization/topics/diphtheria/en/index1.html Accessed on October 7, 2016
- ↑ 6.0 6.1 6.2 Jayashree M, Shruthi N, Singhi S (2006). "Predictors of outcome in patients with diphtheria receiving intensive care". Indian Pediatr. 43 (2): 155–60. PMID 16528112.
- ↑ 7.0 7.1 http://www.cdc.gov/diphtheria/clinicians.html Accessed on October 7, 2016
- ↑ http://www.cdc.gov/diphtheria/about/complications.html Accessed on October 7, 2016
- ↑ Anima H, Malay M, Santanu H, Rajashree R, Sita C, Baran SA (2008). "A study on determinants of occurrence of complications and fatality among diphtheria cases admitted to ID & BG Hospital of Kolkata". J Commun Dis. 40 (1): 53–8. PMID 19127670.
- ↑ Reidermann MI (1996). "[Cardiac complications in adult diphtheria: analysis of 212 cases]". Praxis (Bern 1994). 85 (51–52): 1647–51. PMID 9026877.
- ↑ Kadirova R, Kartoglu HU, Strebel PM (2000). "Clinical characteristics and management of 676 hospitalized diphtheria cases, Kyrgyz Republic, 1995". J Infect Dis. 181 Suppl 1: S110–5. doi:10.1086/315549. PMID 10657201.
- ↑ Logina I, Donaghy M (1999). "Diphtheritic polyneuropathy: a clinical study and comparison with Guillain-Barré syndrome". J Neurol Neurosurg Psychiatry. 67 (4): 433–8. PMC 1736572. PMID 10486387.
- ↑ Kneen R, Nguyen MD, Solomon T, Pham NG, Parry CM, Nguyen TT; et al. (2004). "Clinical features and predictors of diphtheritic cardiomyopathy in Vietnamese children". Clin Infect Dis. 39 (11): 1591–8. doi:10.1086/425305. PMID 15578357.