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By : Dina Israni Putri
Diphtheria
Corynebacterium diphtheriae
acute infectious disease
spreads easily
attacked mainly the upper respiratory tract
a typical pseudomembranous formation
Corynebacterium diphtheriaeGram-positive,aerobic,nonmotile,rod-shaped bacteria. characteristic of forming irregular shaped, club-shaped or V-shapedChinese letters.
Airborne respiratory
droplets
Exudates from infected skin
lesions
Direct contact with
respiratory secretions
Clinical SymptomsThe incubation period : 2-6 daysUsually the disease slightly veiled attacks, such as :
- mild sore throat-heat is not high, ranging between 37.8 º C - 38.9 º C. -Initially only throat hiperemis but most have occurred membranes white / grayish.
Within 24 hours of the membrane can spread and cover the tonsils, palate Molle, uvula.
At - first, a thin membranewhite and webbed becomes thick gray / black difficult to be lifted
According to its severity, the disease is divided into 3 levels• Mild infections
pseudomembran only found in the nasal mucosa with only symptoms of painful swallowing
• Moderate Infection -pseudomembran have attacked until the pharynx-swelling of the larynx
• Severe infection-severe respiratory obstruction -with complication (myocarditis , paralysis and Nefritis)
Nasal diphtheria- Cold- Secretions that come out mixed a little blood from pseudomembranous
Pharyngeal and Tonsillar Diphtheria- Acute Sore throat- Pseudomembranous extend to the nasopharynx and larynx- Breath odor- bullneck
Larygeal anf Tracheal Diphtheria- Hoarseness and stridor- dispnea, cyanosis and looked suprasternal and epigastrium retraction - bull neck
ImmunizationDPTType : - DTwP (whole pertusis)
- DTaP ( accellular pertusis)Dossage : 0,5 mg IM or subcutan
DosePrimary 1Primary 2Primary 3Primary 4
Age2 months4 months6 months15-18 months
Interval ---4 wks4 wks6 mos
DTaP, DT
Td, Tdap (adult)
Diphtheria7-8 Lf units
2-2.5 Lf units
Tetanus5-12.5 Lf units
5 Lf units
DTaP and pediatric DT used through age 6 years. Adult Td for persons 7 years and older. Tdap for persons 10 through 64 years or 11 through 64 years
Routine DTaP Schedule for Children Younger Than 7 Years of Age
4 through 6 years of age, before entering school
11 or 12 years of age if 5 years since last dose (Tdap)
Every 10 years thereafter (Td)
Booster Doses
Dose*Primary 1Primary 2Primary 3
Interval ---4 wks6 to 12 mos
Booster dose every 10 years
*For children 10 years of age and older ACIP recommends that one of these doses (preferably the first) be administered as Tdap
TreatmentNon spesific Spesificcomplete bed rest, isolation of patients soft foods are easily
digested, contains enough protein and calories
Antibiotic- Penicilin procain- Eritromicin- Linkomicin
ADSCorticosteroid
Type Doses
Nasal Diphtheria 20.000 Intramuskular
Tonsingeal Diphtheria 40.000 Intramuskular/intravena
Faringeal Diphtheria 40.000 Intramuskular/intravena
Laringeal Diphtheria 40.000 Intramuskular/intravena
Combination 80.000 Intravena
Diphtheria+ complication, Bull Neck 80.000-120.000 Intravena
Late treatment (>72 h), in anywhere 80.000-120.000 Intravena
Prognosis1. Age of patients
2. Antitoxin treatment time
3. Type of clinical diphtheria
4. Patient's general condition
Thank You
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