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<link rel="alternative" hreflang="en" href="https://medlineplus.gov/ency/article/001608.htm"/><meta property="og:title" content="Diphtheria: MedlinePlus Medical Encyclopedia"/><meta property="og:url" content="https://medlineplus.gov/ency/article/001608.htm"/><meta property="twitter:title" content="Diphtheria: MedlinePlus Medical Encyclopedia"/><meta name="twitter:card" content="summary_large_image"/><meta name="description" content="Diphtheria is an acute infection caused by the bacterium Corynebacterium diphtheriae."/><meta itemprop="description" name="description" content="Diphtheria is an acute infection caused by the bacterium Corynebacterium diphtheriae."/><meta property="og:description" content="Diphtheria is an acute infection caused by the bacterium Corynebacterium diphtheriae."/><meta property="twitter:description" content="Diphtheria is an acute infection caused by the bacterium Corynebacterium diphtheriae."/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_1.jpg"/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_2.jpg"/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_3.jpg"/><meta property="twitter:image" content="https://medlineplus.gov/images/share_ency_1.jpg"/>
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</div><div><span>Diphtheria</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Diphtheria</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Diphtheria is an <a test="test" href="./002215.htm">acute</a> infection caused by the bacterium <em>Corynebacterium diphtheriae</em>.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>The bacteria that cause diphtheria spread through respiratory droplets (such as from a cough or sneeze) of an infected person or someone who carries the bacteria but has no symptoms.</p><p>The bacteria most commonly infect your nose and throat. The throat infection causes a gray to black, tough, fiber-like covering, which can block your airways. In some cases, diphtheria infects your skin first and causes <a test="test" href="./003220.htm">skin lesions</a>.</p><p>Once you are infected, the bacteria make dangerous substances called toxins. The toxins spread through your bloodstream to other organs, such as the heart and brain, and cause damage.</p><p>Because of widespread vaccination (immunization) of children, diphtheria is now rare in many parts of the world. </p><p>Risk factors for diphtheria include crowded environments, poor hygiene, and lack of immunization.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Symptoms usually occur 2 to 5 days after the bacteria enter your body:</p><ul><li>
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Fever and chills</li><li>Sore throat, <a test="test" href="./003054.htm">hoarseness</a></li><li>Painful swallowing</li><li>Croup-like (barking) cough</li><li><a test="test" href="./003048.htm">Drooling</a> (suggests airway blockage is about to occur)</li><li><a test="test" href="./003215.htm">Bluish coloration of the skin</a></li><li>Bloody, watery drainage from nose</li><li>Breathing problems, including difficulty breathing, fast breathing, high-pitched breathing sound (<a test="test" href="./003074.htm">stridor</a>)</li><li>Skin sores (usually seen in tropical areas) </li></ul><p>Sometimes there are no symptoms.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Your health care provider will perform a physical exam and look inside your mouth. This may reveal a gray to black covering (pseudomembrane) in the throat, <a test="test" href="./003097.htm">enlarged lymph glands</a>, and swelling of the neck or vocal cords.</p><p>Tests used may include:</p><ul><li><a test="test" href="./007621.htm">Gram stain</a> or <a test="test" href="./003746.htm">throat culture</a> to identify the diphtheria bacteria</li><li>Toxin assay (to detect the presence of the toxin made by the bacteria)</li><li><a test="test" href="./003868.htm">Electrocardiogram</a> (ECG) </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>If your provider thinks you have diphtheria, treatment will likely be started right away, even before test results come back.</p><p>Diphtheria antitoxin is given as a shot into a muscle or through an IV (<a test="test" href="./002383.htm">intravenous</a> line). The infection is then treated with antibiotics, such as penicillin and erythromycin.</p><p>You may need to stay in the hospital while getting the antitoxin. Other treatments may include:</p><ul><li>Fluids by IV</li><li>Oxygen</li><li>Bed rest</li><li>Heart monitoring</li><li>Insertion of a breathing tube</li><li>Correction of airway blockages</li></ul><p>People without symptoms who carry diphtheria should be treated with antibiotics.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>Diphtheria may be mild or severe. Some people do not have symptoms. In others, the disease can slowly get worse. Recovery from the illness is slow.</p><p>People may die, especially when the disease affects the heart. </p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>The most common complication is inflammation of the heart muscle (<a test="test" href="./000149.htm">myocarditis</a>). The nervous system is also frequently and severely affected, which may result in temporary <a test="test" href="./003190.htm">paralysis</a>.</p><p>The diphtheria toxin can also damage the kidneys.</p><p>There can also be an allergic response to the antitoxin.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Contact your provider right away if you have come in contact with a person who has diphtheria.</p><p>Diphtheria is a rare disease. It is also a <a test="test" href="./001929.htm">reportable disease</a>, and any cases are often publicized in the media. This helps you to know if diphtheria is present in your area.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>Routine childhood immunizations and adult boosters prevent the disease.</p><p>Anyone who has come into contact with an infected person should get an <a test="test" href="./007594.htm">immunization</a> or booster shot against diphtheria, if they have not already received it. Protection from the vaccine lasts only 10 years. So it is important for adults to get a booster vaccine every 10 years. The booster is called tetanus-diphtheria (<a test="test" href="./007610.htm">Td</a>). (The shot also has vaccine medicine for an infection called <a test="test" href="./000615.htm">tetanus</a>.)</p><p>If you have been in close contact with a person who has diphtheria, contact your provider right away. Ask whether you need antibiotics to prevent getting diphtheria.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Respiratory diphtheria; Pharyngeal diphtheria; Diphtheric cardiomyopathy; Diphtheric polyneuropathy</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Centers for Disease Control and Prevention website. Diphtheria. <a href="https://www.cdc.gov/diphtheria/about/index.html" target="_blank">www.cdc.gov/diphtheria/about/index.html</a>. Updated September 9, 2022. Accessed March 14, 2024.</p><p>Saleeb PG. Corynebacterium diphtheriae (diphtheria). In: Bennett JE, Dolin R, Blaser MJ, eds. <em>Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases</em>. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 204.</p><p>Stechenberg BW. Diphtheria. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. <em>Feigin and Cherry's Textbook of Pediatric Infectious Diseases</em>. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 90.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 12/31/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.</p>
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