By : Dina Israni Putri

Corynebacterium
diphtheriae

acute infectious spreads

disease
Diphtheria
easily

a typical attacked mainly the

pseudomembranous upper respiratory
formation tract
Corynebacterium
diphtheriae
Gram-positive,
aerobic,
nonmotile,
rod-shaped bacteria.
characteristic of
forming irregular
shaped, club-shaped or
V-shaped
Chinese letters
.
 Airborne Direct contact
respiratory with respiratory
droplets secretions

Exudates from
infected skin
lesions
Clinical Symptoms
The incubation period : 2-6 days
Usually 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 membranewhite 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
Immunization
DPT
 Type : - DTwP (whole pertusis)
- DTaP ( accellular pertusis)
 Dossage : 0,5 mg IM or subcutan
Dose Age Interval
Primary 1 2 months ---
Primary 2 4 months 4 wks
Primary 3 6 months 4 wks
Primary 4 15-18 6 mos
months
 Diphtheria Tetanus
DTaP, DT 7-8 Lf units 5-12.5 Lf units

Td, Tdap (adult) 2-2.5 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
Booster Doses
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)
 Dose* Interval
Primary 1 ---
Primary 2 4 wks
Primary 3 6 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
Treatment
Non spesific Spesific
complete bed rest, Antibiotic
isolation of patients - Penicilin procain
soft foods are easily digested, - Eritromicin
contains enough protein and - Linkomicin
calories
ADS
Corticosteroid
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

Prognosis
1. Age of patients

2. Antitoxin treatment time

3. Type of clinical diphtheria

4. Patient's general condition

Thank You