Diphtheria natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2] Aysha Anwar, M.B.B.S[3]
Overview
Diphtheria is a vaccine preventable disease which can lead to severe complications like respiratory failure, myocarditis, polyneuropathies and death once the disease sets in.
Natural History, Complications, and Prognosis
Natural history
Complications
Complications that can develop as a result of diphtheria are:[1][2][3][4][5][6][7]
- Respiratory failure
- Myocarditis
- Heart failure
- Polyneuropathies
- 10th cranial nerve disorder
- 9th cranial nerve disorder
- Peripheral motor neuropathy
- Diaphragm paralysis
- Neurogenic bladder dysfunction
- Acute renal failure
- Septicemia
- Death
Prognosis
The overall case-fatality rate for diphtheria is 5%–10%, with higher death rates (up to 20%) among persons younger than 5 and older than 40 years of age.[8] Prognosis of diphtheria varies based on following factors:[9][10][11][12]
Good prognostic factors
- Early diagnosis and treatment
- Age>15 years
- Absence of cardiac involvement
Poor prognostic factors
- Delayed diagnosis and treatment
- Age<15 years
- Presence of cardiac involvement
- Presence of complications
- Immunocompromised status
References
- ↑ http://www.cdc.gov/diphtheria/about/complications.html Accessed on October 7, 2016
- ↑ MORGAN BC (1963). "CARDIAC COMPLICATIONS OF DIPHTHERIA". Pediatrics. 32: 549–57. PMID 14069096.
- ↑ Anima H, Malay M, Santanu H, Rajashree R, Sita C, Baran SA (2008). "A study on determinants of occurrence of complications and fatality among diphtheria cases admitted to ID & BG Hospital of Kolkata". J Commun Dis. 40 (1): 53–8. PMID 19127670.
- ↑ Reidermann MI (1996). "[Cardiac complications in adult diphtheria: analysis of 212 cases]". Praxis (Bern 1994). 85 (51–52): 1647–51. PMID 9026877.
- ↑ Sanghi V (2014). "Neurologic manifestations of diphtheria and pertussis". Handb Clin Neurol. 121: 1355–9. doi:10.1016/B978-0-7020-4088-7.00092-4. PMID 24365424.
- ↑ Jain A, Samdani S, Meena V, Sharma MP (2016). "Diphtheria: It is still prevalent!!!". Int J Pediatr Otorhinolaryngol. 86: 68–71. doi:10.1016/j.ijporl.2016.04.024. PMID 27260583.
- ↑ http://www.who.int/immunization/topics/diphtheria/en/index1.html Accessed on October 7, 2016
- ↑ http://www.cdc.gov/diphtheria/clinicians.html Accessed on October 7, 2016
- ↑ Kadirova R, Kartoglu HU, Strebel PM (2000). "Clinical characteristics and management of 676 hospitalized diphtheria cases, Kyrgyz Republic, 1995". J Infect Dis. 181 Suppl 1: S110–5. doi:10.1086/315549. PMID 10657201.
- ↑ Logina I, Donaghy M (1999). "Diphtheritic polyneuropathy: a clinical study and comparison with Guillain-Barré syndrome". J Neurol Neurosurg Psychiatry. 67 (4): 433–8. PMC 1736572. PMID 10486387.
- ↑ Kneen R, Nguyen MD, Solomon T, Pham NG, Parry CM, Nguyen TT; et al. (2004). "Clinical features and predictors of diphtheritic cardiomyopathy in Vietnamese children". Clin Infect Dis. 39 (11): 1591–8. doi:10.1086/425305. PMID 15578357.
- ↑ Jayashree M, Shruthi N, Singhi S (2006). "Predictors of outcome in patients with diphtheria receiving intensive care". Indian Pediatr. 43 (2): 155–60. PMID 16528112.