Diphtheria - acute infectious disease with the airborne mechanism of transfer; it is characterized by a croupous inflammation of a mucosa in infection atriums - in fauces, to a nose, a larynx, a trachea, less often in other organs - and an intoxication.

Etiology, pathogenesis. The originator - a toxicogenic diphtheritic rod, Gram-positive, steady in an environment. Pathogenic action is bound to ectotoxin. The diphtheritic rod extends on mucosas of fauces and other organs where the croupous inflammation with formation of Membranulas develops. Ectotoxin produced by the originator is soaked up in a blood and. Causes an intoxication with a lesion of a myocardium, peripheric and vegetative nervous system, kidneys, adrenals.

Signs, current. An incubation interval - from 2 till 12 days. Depending on localization of process distinguish a diphtheria of a fauces, a nose, a larynx, eyes, etc.

Diphtheria of fauces. The catarral (atypical) form of disease is shown by a subfebrile condition, morbidity in a throat at a swallowing, a hyperemia of tonsils, small augmentation of regional lymph nodes. To typical forms of a diphtheria of fauces concern localized, widespread and toxic. At the localized form fibrinous membraneous scurfs on palatine tonsils (the membraneous form) are formed. The pain at a swallowing is expressed moderately or weakly, regional lymph nodes are enlarged slightly. The intoxication is not expressed, temperature reaction moderated.

The diphtheria of a larynx (diphtheritic, or true, the croup) recently meets seldom, are characterized by a croupous inflammation of a mucosa of a larynx (the localized form of disease), and sometimes and tracheas (the widespread form). Disease quickly progressing. In the first catarral stage proceeding of 1-2 days, the fervescence usually moderated, the tussis in the beginning "barking", then losing the sonority is observed. In the second stage signs of a stenosis of the top respiratory ways accrue: noisy respiration, a strain at an inspiration of an auxiliary respiratory musculation, inspiratory retractions of compliant places of a thorax. The third (asphyxial) stage is shown by the expressed frustration of gas exchange - a cyanosis, abaissement of pulse at height of an inspiration, a sweating, anxiety. If was well-timed do not render medical assistance, the patient dies of an asphyxia.

The diphtheria of a nose, conjunctiva of eyes, external genitals recently is not observed almost. The complications arising mainly at a toxic diphtheria of 2 and 3 degrees are characteristic, especially at late begun treatment. In the early period of illness signs of vascular and intimate delicacy can accrue. The myocarditis is taped more often on the second week of illness and characterized by disturbance of ability to reduce a myocardium and its spending system. The involution of a myocarditis occurs rather slowly. A myocarditis - one of the reasons of mors at a diphtheria. Monoradiculoneurites and polyradiculoneurites are shown by flaccid peripheric paresises and paralyses of a soft palate, external muscles of an eye, muscles of extremities, necks, trunks. Danger to a life paresises and paralyses of laryngeal, respiratory intercostal muscles represent, diaphragms and a lesion of spending system of heart. There can be the complications caused by a secondary bacteriemic infection (pneumonias, otites, etc.) . As acknowledgement of the diagnosis allocation of toxicogenic diphtheritic rods serves. To differentiate it is necessary from anginas, an infectious mononucleosis, « false croup », a membraneous adenoviral conjunctivitis (at a diphtheria of an eye).