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Complications
By Mayo Clinic staffLeft untreated, diphtheria can lead to:
- Breathing problems. Diphtheria-causing bacteria may produce a toxin. This toxin damages tissue in the immediate area of infection — the nose and throat, for example. This localized infection produces a tough, gray-colored membrane — which is composed of dead cells, bacteria and other substances — on the inside of your nose and throat. This tough membrane, or covering, is dangerous because it can obstruct breathing.
- Heart damage. The diphtheria toxin may spread through your bloodstream and damage other tissues in your body, such as your heart muscle. One complication of diphtheria is inflammation of the heart muscle (myocarditis). Signs and symptoms of myocarditis include fever, vague chest pain, joint pain and an abnormally fast heart rate. Damage to the heart from myocarditis may be only slight, showing up as minor abnormalities on an electrocardiogram, or very severe, leading to congestive heart failure and sudden death.
- Nerve damage. The toxin can also cause nerve damage, targeting certain nerves such as those to the throat, making swallowing difficult. Nerves to the arms and legs also may become inflamed, causing muscle weakness. In severe cases, nerves that help control the muscles used in breathing may be damaged, leading to paralysis of these muscles and trouble breathing.
With treatment, most people with diphtheria survive these complications, but recovery is often slow. Diphtheria is fatal in as many as one in 10 cases.
References
- Diphtheria. World Health Organization. http://www.who.int/mediacentre/factsheets/fs089/en/. Accessed Feb. 12, 2009.
- Diphtheria. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec14/ch172/ch172c.html. Accessed Feb. 12, 2009.
- Pegram PS. Epidemiology and clinical features of diphtheria. http://www.uptodate.com/home/index.html. Accessed Feb. 12, 2009.
- Bortolussi R, et al. Aerobic gram-positive bacilli. In: Cohen J, et al. Cohen & Powderly: Infectious Diseases. 2nd ed. St. Louis, Mo.: Mosby; 2004:2153.
- Daybell DK. Diagnosis and treatment of diphtheria. http://www.uptodate.com/home/index.html. Accessed Feb. 12, 2009.
- Recommended immunization schedule for persons aged 0 through 6 years. U.S. Department of Health and Human Services. http://www.cdc.gov/vaccines/recs/schedules/downloads/child/2009/09_0-6yrs_schedule_pr.pdf. Accessed Feb. 12, 2009.
- Vaccines and preventable diseases: Diphtheria vaccination. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/vpd-vac/diphtheria/default.htm. Accessed Feb. 12, 2009.
