Symptoms of diphtheria in children and adults that must be watched out for

Diphtheria is the scourge of a disease that has again plagued Indonesia since 2017. In severe cases, diphtheria can spread to other organs such as the skin, nervous system, and even to the heart. The effects of diphtheria can be more fatal if it occurs in children. Therefore, consider the symptoms and signs of diphtheria that parents need to know.

Diphtheria transmission

In Indonesia, diphtheria is again endemic due to a lack of public awareness of the importance of diphtheria immunization and vaccination.

In fact, children and adults who have never received the vaccine are most at risk of transmitting diphtheria.

Diphtheria is caused by a bacterial infection Corynebacterium diphtheriae . Diphtheria is usually transmitted through direct contact with sufferers.

Whether it's direct skin contact by holding objects contaminated with diphtheria bacteria, or from breathing air containing bacterial particles.

Symptoms or signs of diphtheria usually do not appear immediately after first exposure to the bacteria.

Generally, new symptoms appear within 2 to 5 days after a person is infected.

The bacteria will go through an incubation period which lasts an average of 1-10 days.

Diphtheria symptoms based on the type

The main symptom or sign of diphtheria is a thick gray membrane which is also known by the term pseudomembrane .

This mucous membrane is composed of leukocytes, bacteria, cell fragments, and fibrin.

This membrane is attached to the tissue at the base so that it can bleed when you try to remove it.

Then, the mucous membrane can spread widely, even covering the entire throat and bronchial branches.

This is one of the things that makes diphtheria a contagious disease because it can obstruct the airway and lead to death.

Medically, the symptoms of diphtheria can be divided into several types based on the part of the body that experiences it.

In the third edition of Manson's Tropical Infectious Diseases, diphtheria is divided into:

• faucial diphtheria that is, the most common type of diphtheria that attacks the respiratory system
• laryngeal diphtheria or laryngeal diphtheria which attacks the vocal cords,
• nasal diphtheria which affects the airways in the nose, and
• cutaneous diphtheri a that affects the skin.

The four types of bacteria will show different signs. It is important for you to recognize every symptom so that you are always on hand for treatment.

1. Symptoms of diphtheria in general

Faucial diphtheria is the most common type of diphtheria, including in children because it can attack the respiratory tract.

Within a few days, cells in the respiratory system die and form a thick gray mucous membrane.

Over time this mucus membrane can widen so that it covers the tongue to the inside of the nose, throat and respiratory tract.

Not infrequently, this membrane causes swelling of the neck and lymph nodes.

The appearance of diphtheria symptoms associated with respiratory disorders generally progress slowly.

Characteristic features fa ucial diphtheria

• Sore throat and hoarseness
• Enlarged lymph nodes; the neck appears swollen
• Blocked nose or nasal discharge
• Fever and chills
• The body feels weak, aches, and pain (malaise)
• Difficulty swallowing
• Cough loud and hoarse

Symptoms of respiratory complications of diphtheria

Apart from the mucous membrane, another symptom or sign of diphtheria is discharge from the nose.

The fluid that comes out is very watery at first, but over time it can drain pus or even mix with blood.

Symptoms of nasal diphtheria are most common in infants and can be mild, unless accompanied by other symptoms that affect the respiratory tract.

4. Symptoms of cutaneous diphtheria

Cutaneous diphtheria or cutaneous diphtheria can cause skin irritation. This type of diphtheria is more common in tropical areas.

If you have this type of diphtheria, the symptoms are usually pain, red spots or rash, and swelling of the skin.

These signs can appear on the skin in the area of ​​the feet and hands.

The rash on the skin will form a mucous membrane or membrane surrounded by red patches.

This mucous membrane can heal within two to three weeks at once will leave scars.

5. Symptoms of malignant diphtheria (malignant diphtheria)

If the infection caused by diphtheria bacteria gets worse, it can cause malignant diphtheria .

The symptoms of diphtheria that appear are more severe, varied, and acute than other types of diphtheria.

More than 50% of cases of malignant diphtheria are fatal and have a high mortality rate.

However, this condition can still be cured with diphtheria treatment.

More mucous membranes appear and spread rapidly to various other parts of the body, such as the roof of the throat, nasopharynx, and nostrils.

In general, these are the symptoms experienced by adults or children when the condition gets worse:

• High fever
• Rapid pulse,
• Swollen neck
• Removes blood from the mouth, nose, and skin

6. Other symptoms of diphtheria

The bacterial infection that causes diphtheria can also take place in other parts of the body, such as the ears and vagina. This can produce symptoms such as ear discharge.

Symptoms due to complications of diphtheria

Diphtheria is a contagious infection whose complications are very dangerous if not treated promptly.

The risk of complications can arise when diphtheria bacterial toxins have attacked vital organs such as the brain, nervous system and heart.

The symptoms of diphtheria are getting worse, indicating the impact of this disease is increasingly endangering the safety of children's lives.

This condition is indicated by the spread of the mucous membrane in the body.

Even though diphtheria sufferers have recovered from infection, the risk of death remains high because of the impact of the poison spreading in the body.

Here are some symptoms or signs of diphtheria in children and adults due to complications, such as:

1. Myocarditis

The toxins released by diphtheria bacteria can also be carried through the bloodstream and damage cells in the body, poisoning the heart.

This condition causes myocarditis, which is inflammation of the wall of the heart muscle.

Heart problems caused by myocarditis can be mild to severe, and can even cause sudden heart failure and death.

General symptoms of myocarditis

Myocarditis which can be characterized by various clinical conditions such as:

• Weakening of heart sounds
• The rhythm of the heart beats rapidly
• Sometimes signs of congestive heart failure appear
• The ventricles of the heart weaken

2. Neuropathy

The nervous system can also be affected by bacterial infections and toxins that occur in the pharynx.

Conditions of toxic neurological or nervous system toxicity are also known as neuropathy or neuritis.

This complication is relatively rare and usually follows a severe respiratory infection caused by diphtheria.

However, complications in the nervous system appear late, generally after 3 to 8 weeks of general diphtheria symptoms persist, even until the symptoms subside.

When the poison from C. diphtheria until it damages the part of the nerve that regulates the respiratory muscles, the muscle can experience paralysis.

As a result, it is impossible for the process of respiration or breathing to take place without aids that support the continuity of breathing.

Symptoms of neuropathy in general

Neuropathy complications are manifested by a number of clinical conditions which include:

• Pharyngeal, laryngeal and respiratory muscle paralysis
• Blurred vision
• The occurrence of regurgitation or fluid that rises up the nose
• Respiratory failure due to weakening of the respiratory muscles
• Weakening of a number of body muscles
• Decreased sensory sensitivity

Some of the other complications caused by diphtheria are acute tubular necrosis, disseminated intravascular coagulation, endocarditis, and secondary pneumonia.

Skin infections associated with diphtheria complications including eczema, psoriasis, or impetigo. In severe cases, diphtheria can cause death.

Not everyone feels the symptoms of diphtheria

In some children or adults, the symptoms of diphtheria are sometimes not obvious.

There are also cases of diphtheria which only cause mild symptoms such as fever in children and sore throat like common cold symptoms.

Even so, it needs to be understood that children who have diphtheria can still infect other people for up to 5-6 weeks after exposure to the initial infection.

Although, the child does not feel sick and shows no sign of diphtheria at all.

When to see a doctor

The initial symptoms of diphtheria are similar to the symptoms of a viral respiratory tract infection, namely a cold or flu.

However, that does not mean you can ignore the symptoms that occur in children.

This is because diphtheria symptoms can develop so that it requires further evaluation from medical personnel.

Therefore, immediately contact the doctor if the child or other family member experiences symptoms or signs of diphtheria like these:

• Severe sore throat that makes it difficult to swallow
• Fever is not high
• Decreased appetite
• Decreased endurance
• Runny nose and difficulty breathing
• Heart rate increases
• Swollen glands in the neck
• Extreme weakness or numbness in the muscles of the body
• The appearance of mucous membranes in the pharynx or throat
• The voice turned hoarse

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