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Cornynebacterium diptheriae
Incubation; 2-5 days


Droplet spread – from nasopharynx of case or carrier.


  • Death rate is 10%(higher in children under 5 and adults over 40).
  • Immunity (natural/vaccine-induced) does not prevent carriage.
  • Up to 5% healthy population in endemic areas test positive from pharyngeal cultures.
  • Largely been eradicated in the developed countries through vaccination programmes.


Organism usually infects the epithelium of the skin and the mucosa of the upper respiratory tract (classically tonsils and pharynx)
  • Inflammation of tissues
  • Bacteria secrete exotoxin which interferes with cell protein synthesis (resulting in tissue necrosis) and call interfere with local neurological supply of palate and hypopharynx (paralysis)
  • Build-up of inflammatory cells, necrotic epithelial cells, and bacteria debris – form the characteristic adherent grey/black, tough, fibre-like covering (pseudomembrane).
  • Inflammation, pseudomembrane formation and paralysis can combine to result in airway obstruction
  • Systemic spread of the toxin in the bloodstream – can injure the kidneys, heart, and brain.

[image from Illnois Department of Public Health, courtesy of US Centers for Disease Prevention and Control]


Culture from throat or nasal swabs (toxin studies must be performed)
**do not delay treatment to wait for diagnosis


Cardiac monitor


DTP (diphtheria–pertussistetanus) vaccination is recommended for all school-age children.


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Dr Tom Leach

Dr Tom Leach MBChB DCH EMCert(ACEM) FRACGP currently works as a GP and an Emergency Department CMO in Australia. He is also a Clinical Associate Lecturer at the Australian National University, and is studying for a Masters of Sports Medicine at the University of Queensland. After graduating from his medical degree at the University of Manchester in 2011, Tom completed his Foundation Training at Bolton Royal Hospital, before moving to Australia in 2013. He started almostadoctor whilst a third year medical student in 2009. Read full bio

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