Swallowing pain
Differential diagnosis of painful swallowing
TONSILITIS, Tonsillitis is part of an acute respiratory tract infection.
Pharyngitis, usually only causes symptoms about 2-5 days after the patient has an infection.
Diphtheria, is a bacterial infection of the nose and throat.
Esophagitis, is inflammation of the esophagus.
Peritonsillar abscess is a bacterial infection that causes pus to appear around the tonsils or tonsils.
Achalasia is a condition when the muscles of the esophagus are unable to push food or drink into the stomach.
The difference between Endotoxins and Exotoxins
Endotoxins are part of the outer portion of the cell wall of gram-negative bacteria. They are liberated when the bacteria die and the cell wall breaks apart.
Exotoxins are produced inside mostly gram-positive bacteria as part of their growth and metabolism. They are then released into the surrounding medium.
Definition of diphtheria
Diphtheria is an acute infectious disease that mainly attacks the tonsils, pharynx, larynx, nose, and sometimes affects the mucous membranes or skin and sometimes also attacks the conjunctiva or vagina. However, cases that occur more frequently are in the form of acute infections that attack the upper respiratory tract.
Classification of diphtheria
Respiratory Type Diphtheria, This type of diphtheria is caused by a toxin-producing (toxigenic) strain of bacteria. Usually it can cause severe symptoms to death. Respiratory type diphtheria is further divided into several types.
Cutaneous/Skin Diphtheria, This diphtheria attacks the skin with mild symptoms accompanied by atypical inflammation and is difficult to recognize, so it is often not included in case records or prevention programs. Caused by toxigenic and nontoxigenic bacterial strains.
Nasal diphtheria (anterior nasal diphtheria)
This diphtheria usually occurs in infants.
Faucial diphtheria
Tracheolaryngeal diphtheria
Malignant diphtheria
Etiology of diphtheria
Corynebacterium diphtheriae.
This bacterium is a type of gram-positive bacteria that does not form spores.
At both ends of these bacteria have metachromatic granules that give an appearance on staining.
Risk Factors of diphtheria
AGENT
HOST
ENVIRONMENT
In diphtheria, the agent in question is C.diphtheriae. This bacterium is considered a primary causal agent, which means that in every case of diphtheria this bacterium will always be found.
Specifically in diphtheria, host factors that play an important role in the occurrence of this disease are age, sex, nutritional status, immunization status.
The physical environment associated with diphtheria includes sunlight entering the house, ventilation area of the house, bedroom occupancy density, room temperature, humidity in the room, and the type of floor of the house. Biological environment such as herd immunity and population density. As well as the social environment such as mobilization.
Diphtheria pathogenesis
C.diphtheriae is a toxin-mediated disease, which means that the signs and symptoms that arise in the disease are caused by a toxin produced by this bacterium.
Diphtheria toxin is a heat-resistant polypeptide that can
lethal at a dose of 0.1 µm/kg. Diphtheria toxin is absorbed into the mucous membranes and causes epithelial destruction and a superficial inflammatory response.
The necrotic epithelium becomes embedded in fibrinous exudate and red and white blood cells, forming a grayish-white pseudomembrane that often lines the tonsils, pharynx, or larynx.
Any attempt to remove the pseudomembrane will damage the capillaries and result in bleeding.
Early management of diphtheria
Patients must be treated in hospital isolation rooms to avoid transmission to other patients. Isolation can be carried out for 48 hours after the administration of antibiotics until it is no longer contagious.
For self-medication there are two main goals, namely to recover the patient from inflammation and the bacterial toxin itself. These treatments include:
ADS (Antidiphteria Serum), is an antitoxin that can bind to toxins in the blood.
Antibiotics in the form of erythromycin or penicillin are given for therapy and prophylaxis.
Passive & active Immunization
Passive immunization is the administration of antibodies to recipients, intended to provide immunity directly without having to produce the active substance for their own immunity.
Active immunization is immunization that is carried out by:
Entering a weakened or killed virus into the body with the aim of stimulating the body to produce its own antibodies.
Diphtheria complications
Inflammation of the heart muscle (myocarditis)
Pneumonia or lung infection
Kidney failure
Nerve damage
Paralysis