Diptheria is caused by corynebacterium diptheriae

1. Diptheria
presented by :
sukhman kaur
Diptheria :
Bsc nursing (3rd year )
subject : child health nursing
supervisor : Ms.Amanjot kaur

2. CONTENTS
1. Introduction
2. Definition
3. Etiology
4. Epidemiology
5. pathogenesis
6. clinical features
7. diagnostic evaluation
8. complications
9. management
10.prevention

3. Introduction
01
diprheria is an acute infectious
d i s e a s e o f c h i l d h o o d
characterized by local inflamation
of epithelial surface, formation of
membrane and severe toxemia

4. Definition:
02.

5. Definition:
Definition
an acute and highly contagious bacterial disease
causing inflammation of the mucous membranes,
formation of a false membrane in the throat which
hinders breathing and swallowing, and potentially
fatal heart and nerve damage by a bacterial toxin
in the blood.
02.

7. Enter Title
Etiology
• Corynebacterium
diphtheriae(gram
positive ,uncapsulated)
• the bacteria most
commly affect nose
and throat
03.

9. 04.
Epidemiology:

10. 04.
• Agent: Cornaebacterium
diptheriae.
• source of infection: Secretion
and discharge from infected
person.
• M o d e o f t r a n s m i s s i o n :
infection is transmitted by
contact or through droplets.
Epidemiology:

11. cont’d: Epidemiology
• Reservior of infection:
Respiratory tract
• Portal of entry : respiratory
tract,conjuctiva or skin
wound
• Incubation peroid: 2-5
days(common in winters
and autumn)
• vulnerable age : preschool
age (3-6 years )

13. 05.
Pathogenesis:

14. 05. Pathogenesis:

15. Enter Title
2 3
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and briefly explain your point of view.
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and briefly explain your point of view.

17. 06.
Clinical
features:

19. Enter Title
clinical
features
• Nasal diptheria
• tonsillar and pharngeal diptheria
• laryngeal diptheria
• Respiratory diptheria
• Cutaneous diptheria

20. Cont’d
• Nasal diptheria
• mild fever
• nasal discharge
• white membrane
on nasal septum
• difficulty in
breathing
• Tonsillar and
pharyngeal diptheria
• anorexia,malaise,low
grade fever,sore
throat and difficulty in
swallowing.
• enlarged lymph node
• blue neck
• respiratory obstruction
• circulatory collapse

21. • Laryngeal diptheria
• noisy and difficult
breathing
• barking cough
• hoarseness of
voice
• progressive stridor
• Respiratory diptheria
• breathing difficulty
• husky voice
• stridor
• enlarged lymph node
• nasal discharge and
swelling of palate
• cutaneous diptheria
• yellow spots and sore
cont’d

22. diagnostic
evaluation :
• the diagnose is based on clinical examination.
• throat culture (gram staining to identify bacteria)
• lab investigation : to check increased WBC
count and raised protein and cells in CSF in
case of neuritis
• ECG to show arrthymias in form of block and
St segment and T wave changes indicate
myocarditis

23. complications:
• breathing problems : the toxin produced by bacteria
damages tissues of nose and throat , the membrane
is produced of grey colour composed of dead
cell ,bacteria and other substances
• this membrane obstructs breathing
Respiratory system :

24. cardiovascular system :
• Myocarditis : inflamation of myocardium
• it is manifested by :
• weak pulse
• soft muffled first heart sound
• extra systole

25. • Nerve damage
• Palatal
• polyneuritis
Nervous system :

26. Renal system:
• Nephritis
• Oliguria
• proteinuria

27. others :
• Secondary bacterial pneumonia.
• Hepatitis.
• lung infection , blood infection and bone infection.

28. 09.
Management :

29. Principles of management :
• Neutralization of free circulating diptheria toxin
• Eradication of bacteria by antibiotics
• supportive and symptomatic treatment
• management of complications

30. Management
medical management
• antibiotics :
1. procaine penicillin
dose : (25000-50000U/kg/day IM ) for 14
days
2. Erythromycin
dose: (40-50 mg/kg / day )

31. Medical management :
1. Antitoxin:
• Antidiptheria serum(ADS) is given
IM or IV after skin sensitivity test .
• dose: for nasal diptheria (20,000
units)
• T & P diptheria (40,000-80,000unit)
• Laryngeal lesions (80,000-
1,20,000units)

32. Prevention:
• 3 doses of 0.5 ml of DPT vaccine (IM or IV) at
anteriolateral aspect of thigh at 6,10,14 weeks of
age
• 2 Booster 0.5 ml at 15-18 month and 5 year of age.
• DT is given instead of DPT as second booster.

35. Nursing manangement:
• Ineffective airway clearance related to
pseudomembrane blocking the airway.
• Hyperthermia related to release of
exotoxin in body .
• Imbalance in nutrition less than body
requirement related to painful
swallowing.

36. summarization:
• .definition: diptheria is acute infectious disease caused
by cornaebacterium diptheriae .
• it spreads through droplet infection , effects respiratory
tract and most often occur in preschool age
• pathogenesis : bacteria enters body - proliferate and
produce exotoxin - local lesion( necrosis and formation
of pseudomembrane )or systemic lesions ( affect
heart,kidney and CNS)
• clinical features : sore throat , fever , nasal
discharge ,bull neck , obstructed airway , circulatory
collapse , enlargemebt in lymph node etc

37. cont’d
• complications are myocarditis ,
breathing difficulty , nephrotis ,
oliguria , palatal paralysis
• management :antitoxin(ADS)and
antibiotics
• prevention :DPT vaccination

38. Recaptualization:
1. what is diptheria ?
2. describe pathogenesis of
diptheria ?
3. describe management of
diptheria ?

39. Bibliography :
• sharma rimple essentials of pediatric
nursing page no. 574-578
• online refrences :
• www.slideshare.net/diptheriae
• https//kgmu.org >pediatrics
• diptheria wikipedia

40. THANK YOU