Clinical Information

Corynebacterium diphtheriae is the etiological agent of diphtheria and occurs in 2 forms, respiratory and cutaneous diphtheria. Respiratory diphtheria may be further classified into pharyngeal, tonsillar, laryngeal, and the less common anterior nasal diphtheria. Due to vaccination programs in the United States, diphtheria is now a rarely reported disease. Corynebacterium diphtheriae is primarily spread by droplets from coughing or sneezing. The incubation period averages 2 to 5 days. The illness is characterized by fever, malaise, and sore throat with a distinguishing thick pseudomembrane present over the involved mucosa. A swab from beneath the pseudomembrane is the preferred specimen for culture. The organisms multiplying at the infection site produce a toxin, diphtheria toxin, which may result in systemic complications affecting the heart, nervous system, etc.

In patients with a clinical diagnosis of possible diphtheria, appropriate specimens should be collected for culture; patients should be placed in appropriate isolation and consideration given to administration of empiric antitoxin (available in the United States through the Centers for Disease Control and prevention) and antibiotics; respiratory and airway support may be required.