DIPHTHERIA By:

Aguilloso, Shella
Cano, Charnelle Jayne G.
Definition
DIPHTHERIA is a serious, infectious disease that
produces a toxin (poison) and an inflammation in
the membrane lining of the throat, nose, trachea,
and other tissues. It causes a sore throat and fever
and may lead to further complications or fatal
diseases. Diphtheria is extremely rare in developed
countries.
Incidence
Children under 5 y/o and
adults over 60 y/o
Mode of transmission
Droplet/ airborne
Outlook (Prognosis)
Diphtheria may be mild or severe. Some people
may not have symptoms. In others, the disease can
slowly get worse.
The death rate is 10%. Recovery from the illness is
slow.
“bull neck” in Diphtheria
Causative Agent
Corynebacterium
diphtheriae
Pathophysiology
Entry of bacteria
 
C. diphtheriae produced toxins
 
inflammatory reaction on body surface at the site of infection (usually the oral
pharynx, from which the process often extends to the nose or larynx)
 
accumulation of inflammatory cells, necrotic epithelial cells, and organism debris
 
causes a gray to black, tough, fiber-like covering at the infection site
(PSEUDOMEMBRANE)

 further infection
 
toxins, produced by the bacteria, can spread through bloodstream to other organs,
such as the heart, and cause significant damage.
 
 
 
Signs and symptoms:
Symptoms usually occur 2 to 5 days after you have come in contact with the
bacteria.
Bluish coloration of the skin
Bloody, watery drainage from nose
Breathing problems
Difficulty breathing
Rapid breathing
Stridor
Chills
Croup-like (barking) cough
Drooling
Fever
Hoarseness
Painful swallowing
Skin lesions
Sore throat (may range from mild to severe)
Diagnostic Exams
PE
Gram stain or throat culture to identify
Corynebacterium diphtheriae
Electrocardiogram (ECG)
CBC
Treatment
 Standard treatment: Diphtheria antitoxin ( I.M. or I.V.)
Hospitalization:
Fluids by IV
Oxygen
Bed rest
Heart monitoring
Insertion of a breathing tube
Correction of airway blockages
Pharmacology:
Metronidazole
Erythromycin (orally or by injection) for 14 days
Procaine penicillin G given intramuscularly for 14 days.
Patients with allergies to penicillin G or erythromycin can use
rifampin or clindamycin.
Nursing Diagnosis
Risk for suffocation related to airway obstruction from
pseudomembrane formation and infected swollen
structures.
Ineffective airway clearance related to
pseudomembrane formation and swollen throat
structures.
Impaired skin related to lesions
Nursing Management
Obtain culture specimens as ordered.
Administer humidified oxygen as indicated and elevate head of
the bed.
Administer drugs as indicated.
Offer frequent, small feedings of liquids and soft foods to the
patient with mild and moderate dysphagia. Give parenteral fluids
as ordered to patient who can’t swallow. Suction as needed.
Maintain strict infection and isolation precautions until 2
consecutive nasopharyngeal culture results are negative for C.
Diphtheria--- at least 1 week after drug therapy stops.
If the patient sustains paralysis, assist him to begin a
rehabilitation program to restore optimal function.
Nursing Interventions….
Monitoring:
Watch for anaphylaxis after giving antitoxins or
antibiotics.
Watch for thrombophlebitis in patients who receive
erythromycin therapy.
Assess respiratory status.
Inspect skin regularly.
Monitor neuromuscular function for weakness,
paralysis, or sensory changes. Notify the physician of
these changes.
THANK
YOU!!!!