Infectious Disease Compendium

Diphtheria

Diagnosis

Sore throat, grey bleeding pseudomembranes, myocarditis and neuropathy with toxigenic strains, non toxigenic strains can cause focal infections anywhere. Cutaneous diptheria is a disease of chronic ulcers of the extremities. Look for it in the homeless alcoholic.

Epidemiologic Risks

Human to human.

Microbiology

C. diphtheriae.

Empiric Therapy

Penicillin OR erythromycin AND antitoxin 20,000 to 40,000 units for pharyngeal or laryngeal disease of 48 hours' duration; 40,000 to 60,000 units for nasopharyngeal lesions; 80,000 to 120,000 units for extensive disease of 3 or more days' duration and neck swelling.

Pearls

Rants

There is this vaccine that prevents the illness. It is way cool, it prevents people from dying. In the old USSR they quit using the vaccine and large numbers of young children died. The anti-vaccine people (aka pro death from infection) are wrong. Well, simple maybe. I look forward to your e-mail.

ICD9 Codes (Soon to be supplanted by ICD10)

Diphtheria 032.9; carrier (suspected) of V02.4; cutaneous 032.85; cystitis 032.84; faucial 032.0; infection of wound 032.85; ; laryngeal 032.3; myocarditis 032.82; nasal anterior 032.2; nasopharyngeal 032.1; neurological complication 032.89; peritonitis 032.83; specified site NEC 032.89.