Diphtheria

Diphtheria, a highly contagious disease, is now rare in most countries but still endemic in many developing nations. Clinical features on presentation include sore throat, difficulty swallowing, low-grade fever, and an adherent pseudomembrane in the throat. Cardiac and neurologic complications may result from the potent exotoxin produced by Corynebacterium diphtheriae. Early diagnosis and prompt treatment with antitoxin, along with antibiotics, are essential for decreasing the risk of death. The only way to reduce the prevalence of diphtheria in endemic countries and prevent future outbreaks and epidemics is through complete vaccination of all children and booster vaccination of adults. The recent increase of cases in some non-endemic regions such as Europe highlights the importance of ensuring universal vaccination. This chapter reviews the epidemiology, clinical features, diagnosis, treatment, and prevention of diphtheria.