BPAG_MSc_diphtheria

BPAG_MSc_diphtheria - Diphtheria Downbutnotout! MarkPallen...

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Diphtheria   Down but not out! Mark Pallen
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Overview What is Diphtheria? Clinical features Epidemiology Bacteriology Prevention and Management Pathogenesis: the toxin Pathogenesis: the rest Conclusion
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What is diphtheria? Acute toxin-mediated disease caused by  Corynebacterium diphtheriae Incubation period 2-5 days  range 1-10 days typically involves pharynx and tonsils but may involve any mucous membrane, e.g. skin
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Clinical Features
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Pharyngeal diphtheria Insidious onset of exudative pharyngitis Exudate spreads to form adherent “pseudomembrane” can lead to respiratory obstruction and death by asphyxiation Fever not high, but patient appears toxic
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Pharyngeal Diphtheria: Local  Features
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Pharyngeal Diphtheria: Distant  Complications Myocarditis Cardiac arrythmias in acute phase Sudden death Prolonged damage and arrythmia Neuropathy Motor neuropathy Paralysis of soft palate from 3rd week Eye muslces, limbs, diaprhagm after 5th  week Spontaneous resolution
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History Ancient Hippocrates 5th C BC? Aretaeus 2nd C AD Aetius 6th C Baillou 1576 Villa Real, Spain, 1611 Nicholaas Tulp, 1716
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History “throat distemper”  New England1735-40 Bretonneau 1862 “diphtherite” Klebs, Loeffler 1880s Von Behring 1890 Glenny, Ramon, 1920s
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BPAG_MSc_diphtheria - Diphtheria Downbutnotout! MarkPallen...

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