Presentation
The specific treatment (diphtheria antitoxin) was not useful in our child as the child presented 4 wk after diphtheria infection. This case report will increase the awareness of sporadic occurrence of a rare disease among fellow pediatricians. [content.iospress.com]
Each entry follows a 5 section structure that will cover (1) essential features of the disorder (2) physiological basis of the disorder (3) neuropsychological and other clinical presentation (4) assessment and diagnostic practices (5) evidence-based treatments [books.google.de]
Limb muscle weakness was present in 94%. Respiratory muscles were involved in 85.4% cases and 60.4% required mechanical ventilation, while 14.6% had fatal outcome and 10.4% had hypoxic neurological injury. Boys were affected more. [ncbi.nlm.nih.gov]
We report an instructive case of diphtheritic polyneuropathy that provides an opportunity to review its typical presentation and management. [jnnp.bmj.com]
Entire Body System
- Malaise
Sign Up A 17-year-old patient has a sore throat, cough, fever, and general malaise for 10 days. Examination reveals that he has a thick silvery-greyish exudate on the tonsils and bilateral cervical adenopathy. [knowledge.statpearls.com]
Unlike streptococcal tonsilitis, diphtheria is often insidious in onset and may be preceded by 2 to 3 days of listlessness, malaise, and headache before local symptoms occur. Cervical adenopathy seems out of proportion to the pharyngeal lesion. [histopathology-india.net]
Case history A 53 year old man developed a severe sore throat and malaise on returning from a Spanish holiday. He was found to have a pyrexia, sloughing tonsillitis, and marked cervical lymphadenopathy. [jnnp.bmj.com]
It affects multiple organ systems, and more than 75% of cases involve neurologic manifestations, which can include various sensory complaints, headaches, dizziness or vertigo, malaise, profound fatigue, circumoral tingling, and pain or tingling in the [medlink.com]
DM hypothyroidism chronic renal failure liver disease intestinal malabsorption malignancy connective tissue diseases [HIV] drug use Vitamin B6 toxicity alcohol and dietary habits •Weight loss, malaise, and anorexia. 31. Diabetes [slideshare.net]
- Infectious Mononucleosis
Polyneuropathy due to infectious mononucleosis Polyneuropathy due to systemic sclerosis Polyneuropathy due to vitamin B complex deficiency Polyneuropathy due to vitamin B deficiency Polyneuropathy in amyloidosis Polyneuropathy in collagen vascular disease [icd9data.com]
Skin
- Ulcer
The corneas are ulcerated, pupils do not react, and he has orthostatic hypotension. (SELECT 1 DIAGNOSIS) a. Charcot-Marie-Tooth disease b. Fabry’s disease c. Riley-Day disease (familial dysautonomia) d. [brainscape.com]
[…] disease, Lupus vulgaris, Prosector's wart ) · Miliary · Tuberculous pericarditis M. leprae Leprosy Nontuberculous R1 : M. kansasii · M. marinum R2 : M. gordonae R3 : M. avium complex ( MAA, MAP, MAI, Lady Windermere syndrome ) · M. ulcerans ( Buruli ulcer [dictionnaire.sensagent.leparisien.fr]
We usually recommend starting treatment with oral prednisolone in patients for whom there are no contraindications (obesity, hypertension, diabetes, ulcer history). If it is not effective we use IVIg, followed by PE. [healthdocbox.com]
Musculoskeletal
- Osteoporosis
Osteoporosis prophylaxis should be started at the same time. NEUROLOGY IN PRACTICE Figure 2 Guillain-Barré syndrome. Mean improvement in disability grade four weeks after randomisation to plasma exchange (PE) or intravenous immunoglobulin (IVIg). [healthdocbox.com]
Neurologic
- Hypesthesia
Sural nerve biopsy leaves a patch of hypesthesia in the lateral aspect of the foot that is usually well tolerated. [neuropathology-web.org]
- Hyporeflexia
Loss of function “- symptoms” Disturbed function “+ symptoms” Motor nerves Large fibre Wasting Hypotonia Weakness Hyporeflexia Orthopedic deformity Fasciculation Cramps The clinical response to motor nerve injury 7. [slideshare.net]
Most case-patients also had hyporeflexia or areflexia (73%, n = 11) and hypotonia of the arms (60%, n = 9) and legs (80%, n = 12). [wwwnc.cdc.gov]
The peripheral neuropathy is responsible for the hyporeflexia that is invariably found in the legs of affected persons. [brainscape.com]
- Clumsiness
Sensory symptoms Pain -pricking,burning type Allodynia Hyperalgesia Neuropathic pain Anaesthesia Tremors-action tremor-in a phase of PNP -slow tremor with clumsiness large fibres affected-AI,CIDP,antimyelinasso GP polyneuropathy 8. [slideshare.net]
- Stupor
Thallium poisoning may produce hair loss, stupor, gastrointestinal distress, seizures, and headaches, as well as a painful, symmetric, primarily sensory neuropathy. [brainscape.com]
Urogenital
- Incontinence
Seizures manifest with a wide spectrum of ictal autonomic manifestations, mainly emesis, syncope-like epileptic seizures (ictal syncope), mydriasis, incontinence, and thermoregulatory and cardiorespiratory irregularities. [medlink.com]
In patients with autonomic neuropathy, postural hypotension, impaired thermoregulatory sweating, postgustatory hyperhidrosis, constipation, flatulence, diarrhea, impotence, urinary retention, and incontinence may occur, and there may be abnormal pupillary [advances-in-medicine.net]
Workup
Diagnostic workup consists of confirming infection and neurophysiological evidence of demyelination. Management is conservative with attention paid to respiration and the airway, which may require mechanical ventilation if significantly impaired. [medlink.com]
Microbiology
- Gram-Positive Rods
Answers Teaching Points Click Your Answer Below Corynebacterium diphtheriae, a gram-positive rod is the causative organism Transmission is only by droplet Neurological and skin manifestations are commonly seen None of the above Would you like to access [knowledge.statpearls.com]
Treatment
Implement proven integrative treatments for various diseases thanks to an evidence-based therapeutic approach. [books.google.de]
At adequate treatment at 75 – 85% of patients good restoration is observed. [herbalthera.com]
Treatment is begun with a plasma exchange or corticosteroids. [infomeds.net]
She was managed with supportive treatment. The specific treatment (diphtheria antitoxin) was not useful in our child as the child presented 4 wk after diphtheria infection. [content.iospress.com]
Prognosis
Prognosis Recovery from peripheral neuropathy is usually slow. Depending on aetiology patient may fully, partially recovered or patient may develop chronic muscular atrophy if severely affected. [orion-group.net]
However, especially in view of the increasing number of European outbreaks, correct differentiation from Guillain-Barré syndrome (table) and other neuropathies is important because the treatment and prognosis are different and because of the importance [jnnp.bmj.com]
↑ Havaldar, PV; Sankpal MN, Doddannavar RP. (2000). [ Expression error: Missing operand for > "Diphtheritic myocarditis: clinical and laboratory parameters of prognosis and fatal outcome."]. [ourmed.org]
The prognosis is generally poor, but some patients respond to intravenous ganciclovir (2.5 mg/kg every 8 hours for 10 days, then 7.5 mg/kg daily 5 days per week). [advances-in-medicine.net]
^ Havaldar, PV; Sankpal MN, Doddannavar RP. (2000). [ Expression error: Missing operand for > "Diphtheritic myocarditis: clinical and laboratory parameters of prognosis and fatal outcome."]. [dictionnaire.sensagent.leparisien.fr]
Etiology
Reasons of the Diphtheritic polyneuropathy: The etiological agent - a diphtheritic stick (Corynebacterium diphtheriae). [en.medicalmed.de]
Despite an extensive evaluation, in approximately half of patients, no etiology is ever found; these patients typically have a predominately sensory polyneuropathy and have been labeled as having idiopathic or cryptogenic sensory polyneuropathy (CSPN) [accesspharmacy.mhmedical.com]
Careful history taking with attention to family history, environmental exposure, and systemic illness, combined with neurological examination and laboratory studies can determine the etiology in most of the cases. [orion-group.net]
ETIOLOGICAL CLASSIFICATION 1.metabolic-DM,amyloidosis,porphyria 2.infections-leprosy,HIV,CMV,syphilis, diphtheria,lymedisease 3.immune- GBS,CIDN,MMN 4.hereditary-CMT 5.Toxic-drugs,alcohol,heavymetals 6.vasculitis-PAN,CSS,cryoglobulinemia [slideshare.net]
Careful history taking with attention to family history, environmental exposure, and systemic illness, combined with neurological examination and laboratory studies can determine the etiology in most peripheral neuropathies. [neuropathology-web.org]
Epidemiology
Epidemiology Diphtheria is a serious disease, with fatality rates between 5% and 10%. [ourmed.org]
The committee uses no specific algorithm or diagnostic criteria for every case but comes to a consensus on the most likely diagnosis on the basis of clinical, laboratory, and epidemiologic data. [wwwnc.cdc.gov]
Pathophysiology
Clinical presentation of the neuropathies depends upon the associated pathophysiologic mechanisms and the anatomical location of the nerve damage. [search.credoreference.com]
Prevention
Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.de]
Centers for Disease Control and Prevention Diphtheria (Medical Encyclopedia) [ Read More ] [icdlist.com]
Khera) Cite This Article Abstract Diphtheritic polyneuropathy is a vaccine-preventable illness caused by exotoxin-producing strains of Corynebacterium diphtheriae. [wwwnc.cdc.gov]
Diphtheria. in: Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book) (10 ed.). [ourmed.org]