CORYNEBACTERIUM

DIPHTHERIAE
Diphtheria
 DIPHTHERIA

Characteristic feature:
Pseudomembrane formation
 WHAT IS IT??

It is an acute infectious disease of

the URT brought about by a
Corynebacterium diphtheriae.
 WHAT IS IT??

Usually begins as pharyngitis

associated with dull red inflammatory
zone of pseudomembrane formation and
lymphadenopathy.
 WHAT IS IT??

Typical symptoms include

thick mucopurulent nasal discharge,
fever, cough, hoarseness of the voice,
soarthroat and swelling of the
lymphnodes.
 THE THREE CLINICAL FORMS

1. Faucial/Pharyngeal

The membrane spreads rapidly from the tonsils across

the soft palate to the uvula and over the Pharyngeal
wall into the naso-pharynx.
 THE THREE CLINICAL FORMS

2. Laryngeal

Membrane formation may easily may easily cause

suffocation.
 THE THREE CLINICAL FORMS

3. Tonsillar

Membrane is confined to the tonsils.

It starts as a small patch on one tonsil and spread to
both.
CORYNEBACTERIUM DIPHTHERIAE
A.K.A "KLEB'S LOEFFLER'S BACILLUS
 CORYNEBACTERIUM DIPHTHERIAE
A.K.A "KLEB'S LOEFFLER'S BACILLUS

Gram (+), aerobic, nonsporeforming, club-

shaped; peomorphic rods in palisade or Chinese
letter character formation
GENERAL CHARACTERIATICS:

 Inhabitsthe URT, GIT Nad urogenital tract of man

 Grows slowly on enriched media

 Resistant to light, dessication and freezing.

 Easily killed by boiling.

 Destroyed by antiseptics

 Resistant to penicillin

 Colonies are black in blood agar with potassium

tellurite.
1. C. diphtheriae var. Gravis

2. C. diphtheriae var. mitis

3. C. diphtheriae var. intermedus

VIRULENCE FACTORS
 Hemolysin
 Dermonicotic toxin
 Diphtheria A-B exotosin
- encoded by tox gene introduced by
lysogenic bacteriophage in virulent strains
of C. diphtheriae.
• Phospholipase D
- increased vascular permeability.
MECHANISM OF ACTION OF DIPHTHERIA TOXIN
MODE OF TRANSMISSION
Dirext contact with patient or carrier through sneezing
or by droplet infection

Indirect contact through the use of contaminated

formites of the patient.
LABORATORY DIAGNOSIS

Microscopic observation of the simple stained

specimen. The findings is confirmed by microscopically
observing presence of Babes-Ernst bodies.
LABORATORY DIAGNOSIS

 Gel diffusion test/Elek test

-Positive result will reveal the appearance of a
thin,white line precipotate in the area where the diphtheria
toxin diffusing sideways from the streak and the diphtheria
antitoxin diffusing paper meet or combine.
TREATMENT
•Early use of diphtheria antitoxin for the
specific, neutralization of exotocin.
•Antibiotic therapy with penicillin or
erythromycin
•Bed rest and isolation to prevent secondary
spread.
•Maintenance of an open airway in patients
with respiratory diphtheria