Diphtheria in children the disease is rare, but extremely dangerous

Treatment of diphtheria in children

Diphtheria in children has become a fairly rare disease. Mass immunization, which has been held for more than half a century, saved Russia and many other countries from epidemics and even localized outbreaks.

But still, to win it quite like a black smallpox or bubonic plague, and failed. Therefore, even today the children still remains a small chance to encounter this infection. Therefore, to have at least a General idea about the disease should all parents.

General information about diphtheria

Diphtheria is one of the most difficult and dangerous childhood diseases. It causes the diphtheria Bacillus (Corynebacterium, Bacillus Leffler). A typical manifestation of the disease – inflammation of the larynx which then goes into the toxic poisoning of the body and the croup.

*footnote Unvaccinated children who contracted diphtheria, without proper treatment, die in 50-70% of cases. With the invention of anti-diphtheria serum that number dropped to 10%, but exclude deaths is not yet possible.

The main danger of diphtheria in the exotoxins that produce these bacteria are in the process of life. They lead to complications: malfunction of the myocardium, kidneys, nervous system, true croup, respiratory depression and so on.

How is the infection?

The main mode of transmission diphtheria is airborne. Less common household from child to child or through contaminated objects, for example, toys, dishes, books. There were cases of mass infection infected products, but it is very rare.

How long is the incubation period depends on many parameters, primarily the age of the child. Than it younger, the higher the speed of disease development. The range of onset of the disease is from 2 to 10 days, on average, the first signs appear after 5 days after contact with an infected person.

Forms diphtheria and course options

Pediatrics has identified several forms of this disease in children. The most frequent localization – oropharynx, which affects primarily the amygdala. There are several variants of course:

• Catarrhal. A localized inflammation of the tonsils, there are local symptoms, General symptoms are minimal or absent. The easiest form with a favorable course. Rare and without treatment can go in common. Catarrhal diphtheria may be in children receiving full course of immunization.
• Common. The inflammation spreads on the tissues located near the tonsils. Possible common symptoms. Found in 10-12% of cases.
• Toxic. The most common form. Toxic diphtheria is tolerated poorly, and can lead to multiple and serious complications. It is characterized by severe General symptoms: high fever, intoxication.
• Hypertoxic. Like toxic pneumonia, caused due to a bacterial secreted substances. For fast and heavy. Without emergency admission and start of treatment can lead to death already on the first or second day.

The most common form is toxic, the rest are rare.

Symptoms and signs of diphtheria

As will appear, the disease is largely depends on the age of the child and the current. Most common lesion of the oropharynx, rarely in the larynx, nose and other sites. So the typical symptoms of diphtheria in children:

• Inflamed tonsils. They reddened, swollen, enlarged. The child has a sore throat, but not too much. Initially, the plaque on the tonsils light, like a spider web, but after a few days they formed a dense off-white membrane forms. It is difficult to remove, by mechanical scraping open of the bleeding surface of the tonsils. 4-5 days after the beginning of the film becomes more friable and can be separated.
• Rise in temperature. In the early stages it does not exceed 38-38,5 degrees, but after a few days can rise to 40 or more.
• The signs of intoxication. A few days after the onset of the disease, the child shows signs of acute intoxication: weakness, lethargy, fever, absent appetite, dry skin, pale.
• The true croup. Diphtheria often causes inflammation of the larynxcereal. Thus the child changes, the voice becomes nasal, rough, sometimes hissing. Simultaneously, there is a heavy, non-productive barking cough. After 2-3 days, the voice disappears. Due to swelling and spasm of the larynx difficult breathing. Without treatment in a few days, growing respiratory failure, possible death.

Possible complications of diphtheria

Diphtheria is a dangerous disease that even today, when adequate treatment may end in the death of a child or persistent side effects.

Most complications of diphtheria in children be a consequence of the following factors:

• Intoxication. The diphtheria Bacillus produces a large amount of toxins that poison the body of the child. Toxic mould can cause damage to the heart muscle, kidneys and nervous tissue, including the brain.
• Diphtheria film. They affect not only the amygdala, but may fall below, narrowing the lumen of the larynx and bronchi. This often leads to respiratory failure.
• Croup. Inflammation of the larynx in diphtheria is extremely dangerous, especially for children in the first years of life. Swelling and constriction of the throat makes breathing difficult, which can cause asphyxia and death.

The most frequent complications:

• Respiratory failure and asphyxia due to filling of the larynx and airway films, swelling or narrowing. Can lead to asphyxiation.
• Myocarditis. Inflammation of the heart muscle develops a few weeks after the onset of the disease, but it may appear in a few days. Causes heart rhythm disturbances, heart failure.
• Polyneuropathy. Muscle weakness, paralysis and atrophy of certain muscles, sensitivity is only part of the manifestations of this condition.

Diagnosis and examination for diphtheria

Because in the first few days for diphtheria is reminiscent of angina, even in a simple inflammation of the throat should consult a pediatrician. The doctor conducts the following examinations:

• Inspection and survey. The doctor examines the throat, paying attention to the size, shape, condition of the tonsils, larynx, palpate lymph nodes, is conducting a survey to determine the status and health of children in the last days.
• Bacterioscopy smear. To exclude the possibility of diphtheria, the doctor will swab of throat and nose. In the laboratory, it is examined under a microscope in search of Corynebacterium, the causative agents of diphtheria.
• A bacteriological swab sample from the throat. With its help it is possible to set the number and type of pathogens, as well as set their sensitivity to different types of antibiotics.
• General analysis of blood. In the results, noted an increase in the number of white blood cells, changes in leukocyte and an increase in ESR.

In addition, the doctor may prescribe additional studies to determine if the disease complications: ECG, ultrasound of internal organs, bronchoscopy and so on. May require consultation with a more narrow specialists: cardiologist, neurologist, nephrologist, and so on.

Treatment of diphtheria in children

Corynebacterium secrete large number of toxins that affect all body tissues, but primarily on the nerves, heart muscle and kidneys. Toxic mold can cause severe and sometimes irreversible damage to these organs. Therefore, the treatment of diphtheria in children is necessary in the shortest possible time.

Serum can not remove toxins that are already bound to tissues, so the rate of administration depends on the health and even life.

In milder forms, it is administered once, in more severe may require multiple injections. How many times and in what dose will be administered a drug depends on the severity and form of the disease.

To deal directly with an agent prescribe a course of antibiotics lasting 10 to 15 days. Apart from anti-diphtheria serum, these drugs are not effective.

Therapy also includes numerous symptomatic treatment: antipyretics, rehydration, detoxification, vitamin therapy. If necessary, designate cardioprotectors, bronchodilators.

Special therapy is required when increasing respiratory distress. The supplemental oxygen helps in mild cases, but sometimes requires mechanical ventilation.

Do I need a quarantine in diphtheria?

Prevention of diphtheria in children requires mandatory isolation of all patients and carriers. Quarantine to prevent spread of this severe and dangerous infection. There are a few mandatory requirements:

• Quarantine for children with suspected diphtheria until receipt of a negative smear microscopy.
• Quarantine children with confirmed diphtheria – after the fullrecovery and receiving two negative sputum smear. How many will last the quarantine depends on the severity of the disease
• Quarantine for children in contact with the sick with dysentery – a week and a negative smear result.

These measures significantly reduce the incidence. And this is especially important today when an increasing number of people refuse vaccinations. Especially high is the number of adults who believe vaccination is necessary only for children.

Today Pediatrics believes vaccination is the only effective way to protect yourself and children from this dangerous and severe disease. Quarantine can only reduce the total number of cases, but did not affect the severity of each case and the likelihood of complications and death.