Diphtheria Treatment Guidelines in Infants

Diphtheria is a dangerous disease that can cause death. Therefore the treatment must be done immediately. When the symptoms of diphtheria begin to arise, then immediately go to the hospital. Consult a kid health specialist to get the correct treatment for your infants.


What is Diphtheria?

Diphtheria is a disease that attacks the mucous membranes in the nose and throat, which in some cases can affect the skin.

According to CDC that The overall case-fatality rate for diphtheria is 5%–10%, with higher death rates (up to 20%) among persons younger than 5 and older than 40 years of age.

Diphtheria is a contagious disease and includes serious infections that can be life-threatening to the sufferer. This disease is very susceptible to children, especially children under the age of five.  Children those ages are still very susceptible to illness because their immune system is still weak.

Diphtheria Symptoms in Infants 

Symptoms of diphtheria usually appear 2 to 5 days after exposure to a bacterial infection. Some people may not experience any symptoms. In some cases, the symptoms of diphtheria also resemble to common flu symptoms. The most common symptoms of this disease are the formation of  gray membrane that covers the throat and tonsils.

However, if your child has the following symptoms, then you should be vigilant, because your child may have diphtheria:

  • Sore throat 
  • Fever
  • Difficulty swallowing
  • The body gets tired quickly
  • Sound becomes hoarse
  • Headache
  •  Swollen lymph glands in the neck
  • Cough
  • Difficulty breathing or shortness of breath
  • The runny nose, initially fluid but gradually becomes thick and sometimes 

In some cases, diphtheria may also cause skin ulcers. The ulcers will disappear within a few months but usually leave marks.

Complications of Diphtheria in Infants 

If your child shows symptoms or suffers from diphtheria then you should immediately see your child to the doctor. If not treated promptly, diphtheria can cause serious complications. Even according to statistics, almost one in five children with diphtheria die from complications. As for some of the complications caused by diphtheria are:

Problems with the respiratory system. The toxin produced by diphtheria bacteria causes the death of the cells and causes the gray membrane in the throat to cause respiratory problems. Depleted membrane particles can also enter the lungs. These conditions can cause inflammation in the lungs so that its function will decrease drastically even can lead to respiratory failure.

Damage to the heart. Toxins due to diphtheria are not only potential to enter the lungs, but also can also to heart and cause damage to the performance of the heart muscle. If the condition occurs then it can cause irregular heartbeats, heart failure, even sudden death.

Nerve damage. Toxins produced by diphtheria bacteria can cause difficulty swallowing, urinary tract problems, paralysis of the diaphragm, also swelling of the nerves of the hands and feet. Problems with the urinary tract are an early indication of nerve paralysis affecting the diaphragm causing respiratory distress. These conditions require that diphtheria patients use breathing apparatus. Such complications may occur suddenly in the early days of infection or within weeks of diphtheria.

Therefore, children with diphtheria are usually advised to stay in the hospital for 1.5 months if they have complications.

Hypertensive diphtheria is a very severe diphtheria complication. This condition will show symptoms of diphtheria in general and is often accompanied by severe bleeding and kidney failure.

Cause and Transmission of Diphtheria in Infants 

Diphtheria is caused by a bacterium called Corynobacterium diphtheriae, a bacterium that usually produces exotoxins. There are 4 main types of bacteria, among them are gravis, intermedius, myitis, and belvanti.

The intermedius type is usually a bacteria that is considered to be an exotoxin producer, although the other three types are also capable of producing exotoxins. The organisms easily attack the tissue lining the throat, and during the invasion they produce an exotoxin that damages the tissues and causes the development of pseudomembranes.

Other bacteria types that do not produce toxins can also cause infections but usually do not cause severe symptoms and sometimes only cause skin infections.

The spread of diphtheria bacteria can easily be done through the air when the sufferer is coughing or sneezing. In addition, there are other ways that can transmit diphtheria and you need to be aware, including:

  • Various objects that have been contaminated by bacteria, such as toys or towels.
  • Direct contact with ulcers in the skin of diphtheria sufferers. Transmission of this kind usually occurs in environments with high population density and environmental cleanliness that is not maintained.
  • Direct contact with animals infected by bacteria, such as cattle.
  • Consuming milk that has not been through the sterilization process. 
  • Consuming dairy products that have not been pasteurized or sterilized.

The bacteria that cause diphtheria will produce toxins and cause death of cells in the throat. The cells that die cause the presence of a gray membrane in the throat. Toxins produced by bacteria can infect the blood and cause heart problems and attack the nervous system.

Patients with diphtheria who have been vaccinated may still be exposed to diphtheria. But usually someone who has been vaccinated will not show symptoms of diphtheria. But you need to be alert because these conditions can cause transmission to your child or yourself.

Diagnosis and Treatment of Diphtheria in Infants 

To diagnose whether your child has diphtheria or not, the doctor will usually make an initial diagnosis of symptoms experienced by the child, such as sore throat accompanied by a gray membrane in the throat. Doctors will usually also take a sample of mucus from the throat, nose, and ulcers to be examined in the laboratory.

If the child is suspected of contracting diphtheria then the doctor will begin treatment, even if the laboratory has not yet been tested. Usually doctors will recommend intensive care at the hospital in the isolation room to prevent transmission. After that the treatment will be done by giving two types of drugs, namely antibiotic and antitoxin treatment.

Antibiotic drugs are useful to prevent bacterial progression and are useful for curing infections. The dose of antibiotics depends on the severity of diphtheria and the duration of the child suffering from diphtheria.

After taking antibiotics for 2 days usually people with diphtheria will not transmit diphtheria bacteria. However, it is important for the child to continue antibiotic treatment until complete. usually for 2 weeks. After completing the treatment, the patient will perform the examination in the laboratory.

If the bacteria that cause diphtheria is still found, then the patient will be advised to take antibiotic treatment again for 10 days.

Meanwhile, antitoxin treatment is useful to neutralize toxins that have spread in the patient's body. Before giving antitoxin drugs to children, the doctor will first determine whether the child is allergic to antitoxin drugs or not. If the child is allergic to antitoxin drugs then the doctor will only give the drug in low doses. Furthermore, the dosage will be increased while looking at the development shown by the child.

If the child has difficulty or shortness of breath due to a gray membrane in the throat, then the doctor may suggest to remove the gray membrane.

If the child also suffers from symptoms of boils, then the doctor will advise to clean boils with soap and water with caution.

Prevention of Diphtheria in Infants 

Prevention of diphtheria in children or adults can be done through vaccination. The vaccine used to prevent diphtheria is the DPT vaccine. The vaccine not only prevents diphtheria, it also prevents tetanus and pertussis or whooping cough. This vaccine is given five times to children at 2 months, 4 months, 6 months, 1.5 to 2 years, and at the age of 5 years.

The vaccine is usually effective to prevent diphtheria infection during a lifetime. But to optimize their effectiveness, children can still get the vaccine in their teens right at the age of 11 to 18 years. Patients with diphtheria who have recovered from the disease are also advised to get diphtheria vaccination because it is still at risk for contracting or infected diphtheria.

For  parents, follow the government regulation for giving the vaccine to the child. If your child has symptoms of diphtheria as mentioned above then immediately consult your child medically in order to get the right treatment and not cause harmful consequences for the child.

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