Министерство науки и
высшего образования РК.
Казахстанско
-
Российский
Медицинский Университет
Presentation on the topic:
Diphtheria
Выполнил:Игисенов Алишер
Курс 1 119Б
Дата: 03.10.2023
Diphtheria is
Diphtheriais an infectious disease of the larynx and upper respiratory tract caused by the bacterium
Corynebacterium diphtheriae (Leffler's bacillus, diphtheria bacillus), the characteristic features of
which are the formation of characteristic "diphtheria" films on the surface of the mucous
membranes, making it difficult to breathe, and severe intoxication
.
Министерство науки и
высшего образования РК.
Казахстанско
-
Российский
Медицинский Университет
Etiology
Causes of diphtheriaThe disease is caused by Corynebacteria. The way of
transmission of diphtheria is airborne, through household items, food products.
Diphtheria bacillus dies when exposed to sunlight, high temperature,
disinfectants.Once in the body, the pathogen causes local inflammation, secretes a
toxin that has an adverse effect on the heart, kidneys, nervous system, adrenal glands.
Epidemiology
The source of infection is sick or healthy carriers of toxigenicdiphtheria
microorganisms. The greatest epidemiological dangeris represented by patients with
diphtheria of the pharynx, nose and larynx, actively releasingpathogens into the
external environment with exhaled air. In this regard, an insignificant role is played
by patients with diphtheria of the eyes, skin, wounds and other localizations,who are
able to spread the infection by contact (through hands, household items).About 90%
of diphtheria diseases are associated with infection from healthy
carrierscorynebacterium. There are 5 types of carriers of diphtheria pathogens:*
transient (detected once), * short-term (lasting up to 2weeks), * of medium duration
(from 15 days to 1 month), * prolonged (up to 6months) and * chronic (more than 6
months).
Symptoms of diphtheria
With diphtheria, the pathological process can be localized on the mucous membrane
of the pharynx, oropharynx, larynx. Fibrinous plaque is formed (elastic, tightly
soldered to the underlying surface, insoluble in water, it is poorly removed, after
removing the plaque, the surface bleeds).
Clinical manifestations differ in the degree
and form of diphtheria.
Pharyngeal diphtheria is most common (90-95% of cases)
Mildto
moderate degree
Severe degree
With a mild degree , there may be:
a slight increase in body temperature lasting up to 2 days;
sore throat;
general weakness, headache;
swelling and redness of the tonsils, with a slight bluish tinge (spots of white-gray
fibrinous plaque, possibly purulent, are noted on them);
enlargement of submandibular lymph nodes.
With a moderate degree, there may be:
an increase in body temperature to high figures, lasting 2-3 days;
sore throat of moderate intensity (does not correspond to the area of the lesion);
redness of the mucosa with a cyanotic tinge, spreading to the mucous membrane
of the oropharynx;
fibrinous plaque on the tonsils in the form of islands or completely covering them,
spreading beyond the tonsils;
pronounced edema of the tonsils, oropharyngeal mucosa;
enlargement of submandibular and cervical regional lymph nodes;
violation of the general condition, weakness, lack of appetite;
vomiting, paleness of the skin, increased heart rate.
A severe degree of the disease may
manifest itself:
severe intoxication syndrome with the development of weakness, weakness, lack of
appetite, pain in the head, muscles and joints, sleep disorders, vomiting, hyperthermia;
sore throat;
redness of the oropharyngeal mucosa with a cyanotic tinge;
enlargement of regional lymph nodes;
fibrinous plaque of gray color, which covers not only the tonsils, but also the palatine
arches, palate, pharyngeal walls;
hemorrhage on the mucous membrane of the palate;
edema of the tonsils, lateral and posterior walls of the pharynx, subcutaneous fat of the
neck;
a sweet smell from the mouth.
Rare forms of diphtheria
Diphtheria of the eyes
Diphtheria of the genitals
Diphtheria of the wounds
Diphtheria of the umbilical wound
Diphtheria of the eye.
he catarrhal type of the disease is very similar to banal conjunctivitis (swelling
and moderate redness of the conjunctiva, serous-purulent discharge from
the conjunctival sac). The filmy form of the disease is characterized by
pronounced swelling of the eyelids and grayish-white films on the
conjunctiva.
Diphtheria of the genitals
Diphtheria of the genitals in men most often develops on the foreskin and around the head,
in women — in the vagina, but can easily spread to the labia, perineum and anus,
accompanied by hemorrhagic discharge. If the inflammation spreads to the urethra area,
urination will be painful.Some patients report an asymptomatic course of diphtheria or the
carriage of diphtheria bacillus. Usually these are people with chronic inflammation of the
nasal cavity and pharynx.
Diphtheria of the wounds
This form of the disease is characterized by: redness of the edges of
damaged tissues, dense infiltration of the surrounding skin, the presence
of a dirty gray plaque and prolonged non-healing of the wound.
Diphtheria of the skin, ear and genitals. These types of diseases are very
rare and occur together with diphtheria of the throat or nose.
DIAGNOSTICS
In the case of the appearance of a characteristic fibrous
plaque on the tonsils and in the nasal cavity, laboratory
diagnostics are used to identify the diphtheria bacillus.
The following analyzes are performed:
•general blood test, indicating the presence of an acute
inflammatory process;
•bacterioscopy (a smear for diphtheria taken from the
tonsils or from the nasal cavity is examined under a
microscope);
•bacteriological examination (the taken biomaterial is
sown in a special nutrient medium, germinated and
studied under a microscope);
•antitoxic antibody titer;
•serological study (specific antibodies in blood serum are
determined).
TREATMENT
Diphtheria treatment is carried out only in a hospital setting. Hospitalization is
compulsory for all patients, as well as for patients with suspected diphtheria and
bacterial carriers. Antibiotics (penicillin or erythromycin) do not affect the lesions
caused by exotoxin, but they limit further bacterial growth and the duration of
carriage of the causative agent of diphtheria, which often continues even after clinical
recovery. The main thing in the treatment of all forms of diphtheria (except for the
carrier of bacteria) is the administration of antitoxic antidiphtheria serum (PDS),
which suppresses diphtheria toxin. The dose of antidiphtheria serum is determined by
the severity of the disease.
Treatment of diphtheria
Patients suspected of having diphtheria are necessarily hospitalized in an infectious or
intensive care unit.Therapy is carried out comprehensively and includes methods of non-drug
and drug treatment.
For the purpose of detoxification, anti-diphtheria serum is administered, the dosage, amount
and method of administration of which are calculated individually, depending on the clinical
situation. Prior to the introduction of serum, an intradermal test is performed to detect
intolerance to the drug. Serum is not administered to children after the 7th day of the disease
without signs of intoxication and plaque on the tonsils.Antibacterial therapy is carried out on
the basis of the results of a bacteriological study. Until the results are obtained, antibacterial
agents are prescribed empirically. The duration of antimicrobial therapy is 10-14 days.
Pharmacotherapy also involves the use of drugs
such as:
antiseptics for topical use (reduce local manifestations of the inflammatory process,
reduce the intensity of pain);
glucocorticoid drugs (reduce tissue edema, are used as a desensitizing agent, for the
prevention of complications);
blood substitutes and saline solutions (reduce the symptoms of intoxication, restore the
water-electrolyte composition of the blood).
Depending on the course of the disease, the presence of complications, therapy is carried
out in accordance with other clinical recommendations.
Prevention of diphtheria
Preventive measures include:
exclusion of contact with a diphtheria patient;
compliance with quarantine measures for patients;
compliance with the rules of personal hygiene;
carrying out anti-epidemic measures in the focus of infection (disinfection of
objects with which the patient came into contact);
carrying out preventive vaccinations against diphtheria, according to the
vaccination calendar.
Vaccination does not prevent the development of the disease, but prevents the
development of a toxic form of the disease, with the development of multiple organ
failure, which can end fatally if timely specific care is not provided.
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D1%8B%20%D0%B4%D0%B8%D1%84%D1%82%D0%B5%D1%80%D0%B8%D
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