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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 — usually, the nose and throat. At that site, the infection produces a tough, gray-colored membrane composed of dead cells, bacteria and other substances. This membrane 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, causing such complications as inflammation of the heart muscle (myocarditis). Heart damage from myocarditis may be slight, showing up as minor abnormalities on an electrocardiogram, or severe, leading to congestive heart failure and sudden death.
- Nerve damage. The toxin can also cause nerve damage. Typical targets are nerves to the throat, where poor nerve conduction may cause difficulty swallowing. Nerves to the arms and legs also may become inflamed, causing muscle weakness. If C. diphtheria toxin damages the nerves that help control muscles used in breathing, these muscles may become paralyzed. Respiration may then become impossible without a respirator or another device to assist with 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. 9, 2011.
- Diphtheria. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/sec14/ch172/ch172c.html. Accessed Feb. 9, 2011.
- Daybell DK, et al. Epidemiology and clinical features of diphtheria. http://www.uptodate.com/home/index.html. Accessed Feb. 9, 2011.
- Overturf GD. Corynebacterium diphtheriae. In: Long SS. Principles and Practice of Pediatric Infectious Diseases Revised Reprint. 3rd ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2009. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-7020-3468-8..50002-X&isbn=978-0-7020-3468-8&uniqId=235245982-7. Accessed Feb. 10, 2011.
- Daybell DK, et al. Diagnosis and treatment of diphtheria. http://www.uptodate.com/home/index.html. Accessed Feb. 9, 2011.
- Recommended immunization schedule for adults aged 19 years and older — United States, 2013. Centers for Disease Control and Prevention http://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html. Accessed Feb. 19, 2013.
- Tetanus, diphtheria (Td) or tetanus, diphtheria, pertussis (Tdap) vaccine: What you need to know. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-td-tdap.pdf. Accessed Feb. 10, 2011.
- Bishai WR, et al. Diphtheria and other infections caused by corynebacteria and related species. In: Fauci AS, et al. Harrison's Online. 17th ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://www.accessmedicine.com/content.aspx?aid=2898307. Accessed Feb. 10, 2011.
- Recommended immunization schedule for persons aged 0 through 18 years — United States, 2013. Centers for Disease Control and Prevention http://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html. Accessed Feb. 19, 2013.
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