Hi, this is Tom, and in this episode I'm going to be going through Diptheria.

And you can find notes at 0.0.0.5.com and in the 0.0 to Finals Pediatrics book.

And you can find flashcards and questions at members.0.0.0.com.

So let's jump straight in.

Diptheria is an acute bacterial infection caused by toxogenic strains, meaning strains that produce a specific toxin, of corneide bacterium

diphtheriae, which is a gram-positive bacillus. The dangerous effects are mainly due to the diphtheria

toxin. Diphtheria can affect the upper respiratory tract in respiratory diphtheria or the skin

in cutaneous diphtheria. It's a serious infection with a mortality around 5 to 10%. Diptheria is spread

through respiratory droplets, close contact with infected people and contact with infected skin lesions.

The incubation period is 2 to 5 days. Let's talk about the vaccine. The diphtheria

vaccine is a toxoid vaccine that pretends against the diphtheria toxin rather than the bacteria.

It's given as part of the UK routine vaccination schedule in the combination vaccines. in the 6 in 1 vaccine at ages 8, 12 and 16 weeks and 18 months,

in the 4 in 1 vaccine at age 3 years and 4 months, and in the 3 in 1 vaccine at age 14 years.

Let's talk about the presentation.

Respiratory diphtheria presents with a sore throat,

low-grade fever,

swollen cervical lymph nodes in the neck,

dysphagia or difficulty swallowing,

and shortness of breath in severe cases.

The classic finding on examination is a thick, grey-white pseudomembrain that covers the tonsils or

the pharynx. This is made of dead epithelial cells, fibrin, white blood cells and bacteria.

It may bleed if it's removed.

...