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Early stages:
Sore throat, Low fever, Swollen neck glands.
Late stages:
Airway obstruction and breathing difficulty. Shock
Diphtheria Toxin (DT)
• Cleaved to yield A/B fragment, joined by S-S bond
- A (catalytic domain)
- B (transmembrane and receptor binding domains)
• Toxin diffuses throughout body via blood
pseudomembrane Bull neck
Cutaneous Diphteria
Treatment
Therapy Children Adults
First Choice •Antitoxin •As for children
Pharyngeal/laryngeal disease (<48 h), 20,000- (erythromycin, 2 g/d in 4
40,000 U IV doses)
Nasopharynx disease, 40,000-60,000 U IV
Extensive disease or >3 d, 80,000-120,000 U IV
PLUS
Erythromycin, 40-50 mg/kg/d (max, 2 g/d)
Rumus: