The incubation period for diphtheria is from 2 to 10 days. When a diphtheria bacillus enters the body, a focus of inflammation develops at the site of its introduction, in which the pathogen multiplies, releasing a toxin.
With lymph and blood, the toxin is carried throughout the body, causing damage to both the mucous membrane (or skin) at the site of introduction of the pathogen, and internal organs and systems. Since the pathogen most often enters the pharynx, local changes most often occur in it. In addition, an inflammatory focus can develop in the nose, larynx, ear, genitals, eyes, wound surface of the skin.
Signs of diphtheria depend on the location of the pathogen. Among the general symptoms characteristic of all forms of the disease, the following can be distinguished:
- thick gray deposits covering the throat and tonsils;
- sore throat and hoarseness;
- swelling of the lymph nodes of the neck and swelling around them (the so-called “bull’s neck”);
- difficulty breathing or rapid breathing;
- discharge from the nose;
- fever and chills;
- general malaise.
Symptoms of diphtheria depending on the clinical form:
Most often (in 90% of all cases of morbidity), diphtheria of the oropharynx occurs. The duration of the incubation period is from 2 to 10 days (from the moment of human contact with the carrier). When Leffler’s stick penetrates the oral mucosa, it damages it and causes tissue necrosis. This process is manifested by severe edema, the formation of exudate, which is later replaced by fibrin films. Hard-to-remove plaque covers the tonsils, can go beyond them, spreading to adjacent tissues.
With diphtheria croup, the larynx, bronchi, trachea can be affected. A strong cough occurs, which leads to the fact that the voice becomes hoarse, the person turns pale, it is difficult for him to breathe, the heart rhythm is disturbed, cyanosis. The pulse becomes weak, blood pressure drops sharply, disturbances in consciousness, and a convulsive state may disturb. The form is dangerous because it can lead to suffocation and death.
Diphtheria of the nose. In cases with nasal diphtheria, a very slight intoxication of the body, bloody discharge, serous-purulent discharge, nasal breathing difficulties will be characteristic. In this form of diphtheria, the nasal mucosa: swollen, hyperemic, with sores, with erosions or fibrinous overlays (easy to remove, look like shreds). Also on the skin around the nose, irritation and crusts sag. Basically, diphtheria of the nose is manifested in combination with: diphtheria of the oropharynx, sometimes eyes, and / or larynx.
With widespread diphtheria, the body temperature first rises to thirty-eight degrees and above. Patients move less, feel tired, sometimes there are attacks of nausea and vomiting. Plaque on the tonsils after a couple of days spreads throughout the oral cavity – on the tongue, pharynx, palate. Lymph nodes are significantly enlarged, they are painful when palpated.
The toxic form is a complication of untreated previous forms. The body temperature rises to 40 ° C, symptoms of intoxication syndrome appear: chills, weakness, joint pain, sore throat. Patients experience vomiting, agitation, euphoria and delirium. The skin turns pale, and the mucous membrane of the pharynx swells and turns red. Complete closure of the larynx is possible. Fibrinous plaque covers most of the mucous membrane of the oropharynx, and the films become coarse and thick. Patients have cyanosis of the lips, heart rate increases, blood pressure drops, and an unpleasant, putrid odor emanates from the mouth.
Early treatment of diphtheria ensures complete recovery without complications, although the duration of the cure depends on the severity of the infection. In the absence of timely treatment, serious complications are possible, including those of the heart, which can lead to coma, paralysis or even death.