Diphtheria: Etiology and Pathology (Pediatric Nursing)

00:01 Now let's cover diphtheria.

00:03 Diphtheria is a bacterial infection that primarily affects the throat and the upper airways.

00:08 This produces a toxin that can infect other organs.

00:12 There's an acute onset of symptoms including a sore throat, fever, and swollen lymph nodes.

00:18 A membrane or a pseudomembrane will develop in the throat making it difficult for the patient to breathe.

00:24 This can be life-threatening and it is vaccine preventable.

00:29 The etiology. This is caused by the bacterium, Corynebacterium diphtheria.

00:34 It usually multiplies on or near the surface of the mucous membranes of the throat.

00:40 It's spread via three routes. The first is droplets.

00:44 Patients can sneeze and cough and expel these droplets into the air.

00:48 They can also share these via contaminated personal items like their own wounds on their skin, used tissues or drinking from the same glass.

00:58 Also, after the patient has coughed there droplets, this can also settle on towels, toys and other contaminated household items.

01:06 Infected patients can spread the bacteria to nonimmune people for up to six weeks even while they're asymptomatic.

01:14 So what happens in the pathology of diphtheria? Well, there's a release of a toxin there's gonna be local growth of the bacterium into the pharynx with a pseudomembrane forming.

01:25 And this is a combination of fibrin, white blood cells, bacteria and dead surface-tissue cells.

01:31 The areas most commonly involved are of the tonsillar zones.

01:35 The larynx which is the voicebox, the soft pallet, the uvula and even in the nose and the nasal cavities.

01:44 This pseudomembrane is going to adhere so tightly it cannot be scraped off by the clinician.

01:49 There will be blockage of the airways by the pseudomembrane, and this is the deadly complication of diphtheria.

01:57 There can be systemic dissemination of this toxin that's going to then spread to the distant organs.

02:03 The incubation time is about 27 days after exposure.

02:07 So, the patients don't even remember where they could've possibly picked this up.