The Correlation Between Diphtheria and Myocarditis

Presented by

Fitri Aulia
030.06.095
Medical Faculty of Trisakti 2007

Diphtheria

Definition Diphtheria is an acute communicable disease primarily affecting the upper respiratory tract. dipthera (Greek) = pair of leather scrolls.

Etiology of Diphtheria
Corynebacterium diphtheriae

History of Diphtheria

Diphtheria was named in 1826 by French physician Pierre Bretonneau. The name alludes to the leathery, sheath like membrane that grows on the tonsils, throat, and in the nose.

Epidemiology of Diphtheria

In 1991 there were 2,000 cases of diphtheria in the USSR. By 1998, according to Red Cross estimates, there were as many as 200,000 cases in the Commonwealth of Independent States, with 5,000 deaths. This was so great an increase that diphtheria was cited in the Guinness Book of World Records as "most resurgent disease".

Diphtheria cases reported to the World Health Organization between 1997 and 2006

Transmission of Diphtheria

Diphtheria is a highly contagious bacterial disease that is transmitted from person to person through close physical and respiratory contact.

Signs and Symptoms of Diphtheria

Fatigue Fever Problems swallowing Nausea Vomiting Bull Neck Fast heart rate

How to Diagnose Diphtheria?

Centers for Disease Control and Prevention (CDC)

Laboratory criteria

Isolation of Corynebacterium diphtheriae from a clinical specimen Histopathologic diagnosis of diphtheria Upper respiratory tract illness with sore throat Low-grade fever An adherent pseudomembrane of the tonsil, pharynx and nose.

Clinical criteria

Diphtheritic Tonsillopharyngitis

Nasal Diphtheria

Cutaneous Diphtheria

Cutaneous Diphtheria

Cutaneous Diphtheria

Cutaneous Diphtheria

Laryngotracheal Diphtheria

Diphtheritic Tonsillitis

Prevention of Diphtheria

Vaccination of DPT (Diphteria, Pertussis and Tetanus) ADT (Adult Diphteria and Tetanus)

Treatments of Diphtheria

Antitoxin Antibiotics

Erythromycin Procaine penicillin G Rifampin Clindamycin

Intubation Tracheotomy

Complication of Diphtheria

Diphtheritic Cystitis Diphtheritic Myocarditis Diphtheritic Peritonitis Cranial Neuritis Periferal Neuritis

Myocarditis

Definition Myocarditis is an inflammatory condition involving the myocardium (heart muscle).

Etiology of Myocarditis

Infectious Immunological Toxic Physical agents

Epidemiology of Myocarditis

The exact incidence of myocarditis is unknown. However, in series of routine autopsies, 19% of all patients had evidence of myocardial inflammation. In young adults, up to 20% of all cases of sudden death are due to myocarditis. In South America, Chagas' disease (caused by Trypanosoma cruzi) is the main cause of myocarditis. The average age of patients with myocarditis is 42 years

Sign and Symptom of Myocarditis

Chest pain Fever A fast heartbeat Tiredness Shortness of breath

How to Diagnose Myocarditis?

Electrocardiogram (ECG) Chest x-ray Ultrasound of the heart (echocardiogram) White blood cell count Red blood cell count Blood cultures for infection Blood tests for antibodies against the heart muscle and the body itself Heart muscle biopsy-rarely performed

Treatment of Myocarditis

Oxygen. Medication to treat heart failure or arrhythmias. A pacemaker if certain arrhythmias develop. Antibiotics if the cause of the myocarditis is a bacterial infection. Steroid medication if the cause is giant-cell myocarditis. Stopping alcohol if alcohol is the cause Reduced level of activity

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Conclusion
Diphtheria is one of dangerous diseases because it can cause many kinds of complication such as Myocarditis, Cystitis, Peritonitis and many others. Myocarditis that is complicated by diphtheria is called diphtheritic myocarditis.

References
www.phac-aspc.gc.ca/.../23s4/23s4g_e.html, accessed on May 17, 2007. www.wikipedia.com, accessed on May 17, 2007. www.patient_UK.com, accessed on May 17, 2007. www.medical-encyclopedia.com, accessed on May 17, 2007 edcp.org/factsheets/diptheria.html, accessed on May 17, 2007. www.dhs.vic.gov.au/phd/immunisation/, accessed on May 17, 2007. Epidemiological Bulletin, Vol. 20 No. 4, December 1999 Arif Mansjoer, and friends. Kapita Selekta Kedokteran, 2000. Media Aesculapius, Jakarta. Lecturers of Medical Faculty of Indonesia University, Ilmu Kesehatan Anak, 1985. Media Aesculapius, Jakarta. Eckart RE, Scoville SL, Campbell CL, Shry EA, Stajduhar KC, Potter RN, Pearse LA, Virmani R. Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med 2004;141:829-34. PMID 15583223

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