Lecture Notes: Diphtheria

DIPHTHERIA Infectious childhood disease Prism: CORYNEBACTERIUM DIPHTHERIAE (Affect throat) causative orgonin Actions produces toxin that causes exudative Pharyngitis and membranous tonsillitis. aram positive, non-capsulated, non-sporing, non-motile bacillus GLUB-SHAPED SWELLINGS -Characteristic Feature - Chinese letter or cuneiform arrangement- Vor L-shaped in smear, bacterial cell divide, daughter cells lie at acute angle. #(ell divisim- snapping type of division Preset at Metachromatic granules Poles of Bacilli METACHROMATIC GRANULES Polar Bodies ar Babes-Ernst Bodies -storage granules, composed of polymetaphosphater Granuler take Bluish colour metachromatic colour when stained with methylene Blue well dev. on enriched media (Blood ager / Loeffler carum slope).. Diptheria toxin is I virulene factor responsible Fur diptheria Fragnet B Binding (Active) Fragm Binds + host-rell -Receptors ↓ ADP ribosylation of almgation Factor 2 (EF-1) Leads to Inhibition of EF-2 inhibition of translation protein synthess. Factors reg. Toxin. productin Iron conc orner-speciel cukoram. Phage coded p-coryneplex (tox-gene) from PATHOGENICITY & CLINICAL MANIFESTATIONS • Pathogenesis- Toxin Mediated. > Diptytheria is toxemia > Non-invasile, present at Local site (Pharynx), secrete toxin spread via blood stream to various organs. > Toxin responsible for all manifestations includio (respiratory) 2x systemic complications (except the skin lesions)" CUTANEOUS DIY RES PP SYS. COMPLI Respiratory Diptheria most common, TONSIL & PHARYNX - most common site Incubation Period- 3-4 days. FAUCAL DIPHTHERIA Elicits an inflammas response, that leads to necrosis of epithelium & exudate formation -heads to formation of mucosal ukers, lined by tough leathery greyish white pseudomembrane coat composed of inner band of Fibrin surrounded by neutrophils, RBC ato -Extension of pseudomembrane in Ext in Long & Bronchial airway, obst Asphyxia. - BULL NECK PIPTHERIA:- Tonsillar swelling & Neck Edeme. Patients present with Fow breath, thick speech, & stridor LUTANEOUS DIPTHERIA SYSTEMIC Afler weeks Polyneuropathy & myocar ditis Other complications prenmonia, RF, Pulembolism. Neurologie manilestations Cranial Rom inv Periph nerupt • Myocarditis ass. with orrythmias & dilated. cardiomyopathy. PATHOGENICITY & CLINICAL MANIFESTATIONS • Pathogenesis- Toxin Mediated. > Diptytheria is toxemia > Non-invasile, present at Local site (Pharynx), secrete toxin spread via blood stream to various organs. > Toxin responsible for all manifestations includio (respiratory) 2x systemic complications (except the skin lesions)" CUTANEOUS DIY RES PP SYS. COMPLI Respiratory Diptheria most common, TONSIL & PHARYNX - most common site Incubation Period- 3-4 days. FAUCAL DIPHTHERIA Elicits an inflammas response, that leads to necrosis of epithelium & exudate formation -heads to formation of mucosal ukers, lined by tough leathery greyish white pseudomembrane coat composed of inner band of Fibrin surrounded by neutrophils, RBC ato -Extension of pseudomembrane in Ext in Long & Bronchial airway, obst Asphyxia. - BULL NECK PIPTHERIA:- Tonsillar swelling & Neck Edeme. Patients present with Fow breath, thick speech, & stridor LUTANEOUS DIPTHERIA SYSTEMIC Afler weeks Polyneuropathy & myocar ditis Other complications prenmonia, RF, Pulembolism. Neurologie manilestations Cranial Rom inv Periph nerupt • Myocarditis ass. with orrythmias & dilated. cordiomyopathy. DIP THERIA TOXIN DEMONSTRATION Following isolation, toxin demonstation, to in vivo or in vitro methods. -Din-vivo texto → Subcutanease & intracutaneem tesks - In vitro tests > Elek's gel precipitation test > Detection of fox-gene by PCR > Detection of toxin by ELISA or ICT > cytotoxicity on rell lines A Typing: Relatede bhi isolates. (dipthie-gravis, inkomen, nilis, balfanti ار foxm prodh vorim virulence k Treatment Antidiptheritic serum or ADS (antitoon) Passive immunization kit dose Earf stage-20,000-40,000 units Antibiotica penicillin or (erythromycin) > Curt-dipthe >Befr toxin Relone 2 consecutive negative Colle. shik test PRO PHYLAXIS Inf-control Kolation Room, droplet precaution.. Post-exp Booster doose of dip. vacins + Peninh. G(single case) orerythingon( 7-10 dep) Vaccination (IN) 25LF / 2 Lf units. Protects the of o of unit in L of antitoxin single vaccine DT To xine+ Formallin Alum (↑mmunage of toxoid) Combined vaccifle> →TdTetants toxoid & Adult love (215) of diphtheria toxoid Children: seven doses, 3 doses of pentavalent vaccine at 6, 10, 14 weeks of Birth, followed by booster doses of DPT at 16-24 months and 5 years and anoll of td at lo yis & lyn. Preg. women: 2 doses of Td at one month pteerd.