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Chapter 67 – Diphtheria

Nicholas J. White,
Tran Tinh Hien


Diphtheria is an acute infectious disease of the tonsils, pharynx, larynx or nose, and occasionally of other mucous membranes or skin, caused by Corynebacterium diphtheriae. The word diphtheria originates from the term ‘diphtherite’, which has a Greek root meaning skin or hide, and refers to the leathery appearance of the characteristic pharyngeal membrane.[1] The disease is caused by the local effects of destructive infection (usually in the nasopharynx) and the distal effects of diphtheria toxin on the heart, peripheral nerves and kidneys. Death results from airways obstruction, myocarditis or polyneuritis. Diphtheria has declined dramatically in affluent countries over the past 80 years,[2,3]but it remains an important disease in many parts of the tropics and there has been a recent resurgence of the disease in the West. Between 1990 and 1999, over 158 000 cases and 4000 deaths were reported in the countries of the former Soviet …