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
- Soft Tissue Swelling
A “bull neck” may arise due to cervical lymphadenopathy and soft tissue swelling. Occasionally the initial site is cutaneous, vaginal or, in neonates, umbilical. [jnnp.bmj.com]
Gastrointestinal
- Gagging
Paralysis of a soft palate, disturbance of sensitivity in a throat, decrease in a gag reflex develop on 3 — the 4th week from the beginning of a disease. [en.medicalmed.de]
Paralysis of a soft palate, disturbance of sensitivity in a throat, decrease in a gag reflex develop in 3 — 4 weeks from the beginning of a disease. [infomeds.net]
Jaw & Teeth
- Tonsillar Exudate
A 29-year-old Haitian man had a sore throat with a marked tonsillar exudate followed by the onset of increasingly blurred vision with swallowing difficulties and, then, a diffuse acute demyelinating neuropathy. [ncbi.nlm.nih.gov]
Abstract A 29-year-old Haitian man had a sore throat with a marked tonsillar exudate followed by the onset of increasingly blurred vision with swallowing difficulties and, then, a diffuse acute demyelinating neuropathy. [prohealth.com]
Cardiovascular
- Retrosternal Chest Pain
Four weeks after the initial onset of symptoms, he experienced an episode of retrosternal chest pain lasting 30 minutes. An ECG and subsequent exercise test were normal. [jnnp.bmj.com]
Neurologic
- Absent Deep Tendon Reflexes
It is considered more likely with higher release of exotoxin ( 6, 7 ) The classic features of diphtheritic polyneuropathy include sensory and motor signs and symptoms, most notably acute flaccid paralysis (AFP) with reduced or absent deep tendon reflexes [wwwnc.cdc.gov]
Urogenital
- Genital Lesions
Diphtheria is clinically defined “as an upper respiratory tract illness characterized by sore throat, low grade fever, and an adherent membrane of the tonsils, pharynx or nose or non-respiratory diphtheria; cutaneous, conjunctival, otic, and genital lesions [wwwnc.cdc.gov]
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
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]
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]
↑ 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]